FIRST-LINE ATEZOLIZUMAB PLUS CHEMOTHERAPY IN CHEMOTHERAPY-NAÏVE PATIENTS WITH ADVANCED NSCLC: A PHASE III CLINICAL PROGRAM
Invited conference paper presented and published in conference proceedings

香港中文大學研究人員

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摘要Background: First-line treatments for patients with advanced NSCLC include targeted therapies and platinum-based doublet chemotherapy±bevacizumab and/or pemetrexed. Although immunotherapies targeting the PD-L1/
PD-1 pathway are available for advanced NSCLC beyond the first line, chemotherapy is a key first-line option for patients, despite poor survival outcomes, highlighting the need for additional treatment options. Atezolizumab, a monoclonal anti–PD-L1 antibody, inhibits the binding of PD-L1 to its receptors PD-1 and B7.1, restoring tumor-specific T-cell immunity. Clinical efficacy has been reported with atezolizumab monotherapy in patients with squamous and nonsquamous NSCLC, with a survival benefit observed across all PD-L1 expression levels. Additionally, Phase Ib data showed the potential for chemotherapy to further enhance responses to atezolizumab, with tolerable safety, in patients with NSCLC. Bevacizumab in combination with atezolizumab may enhance efficacy in non-squamous NSCLC by inhibiting VEGF-mediated immunosuppression. Four global, Phase III, randomized, open-label trials are evaluating atezolizumab+platinumbased chemotherapy±bevacizumab in chemotherapy-naive patients with stage IV NSCLC. Methods: Eligible patients must have stage IV NSCLC, measurable disease (RECIST v1.1) and ECOG PS 0-1 and be chemotherapy naive. Exclusion criteria include untreated CNS metastases, autoimmune disease and prior exposure to immunotherapy. Patients will be enrolled regardless of PD-L1 expression status. Patients randomized to the experimental arm will receive atezolizumab 1200 mg with standard platinum-based
chemotherapy in IMpower130 and 131 and also ±bevacizumab in IMpower150 for four or six 21-day cycles, then maintenance with atezolizumab in IMpower130 and 131 and atezolizumab+bevacizumab in IMpower150. In
IMpower132, experimental-arm patients will receive atezolizumab+platinumbased chemotherapy+pemetrexed, then maintenance with atezolizumab+pemetrexed. Patients receiving atezolizumab may continue until loss of clinical benefit. Co-primary endpoints are progression-free survival and overall survival. Secondary endpoints include objective response rate and safety. Evaluation of predictive biomarkers associated with efficacy will be performed.
著者Frederico Cappuzzo, Martin Reck, Vassiliki Papadimitrakopoulou, Robert Jotte, Howard West, Tony Mok, Alan Sandler, Simonetta Mocci, Shelley Coleman, Takashi Asakawa, Mark Socinski
會議名稱IASLC 17th World Conference on Lung Cancer
會議開始日04.12.2016
會議完結日06.12.2016
會議地點Vienna
會議國家/地區德國
會議論文集題名Journal of Thoracic Oncology
叢書冊次P3.02C
出版年份2017
月份1
卷號12
期次Suppl 1
頁次S680 - S681
語言英式英語
關鍵詞atezolizumab

上次更新時間 2018-18-01 於 08:19