Results from the IMpower132 China cohort: Atezolizumab plus platinum-based chemotherapy in advanced non-small cell lung cancer

Shun Lu, Jian Fang, Ziping Wang, Yun Fan, Yunpeng Liu, Jianxing He, Jianying Zhou, Jie Hu, Jinjing Xia, Wenxin Liu, Jane Shi, Jing Yi, Lejie Cao, Shun Lu, Jian Fang, Ziping Wang, Yun Fan, Yunpeng Liu, Jianxing He, Jianying Zhou, Jie Hu, Jinjing Xia, Wenxin Liu, Jane Shi, Jing Yi, Lejie Cao

Abstract

Background: The global Phase III IMpower132 study evaluating atezolizumab plus pemetrexed and carboplatin or cisplatin (APP) versus pemetrexed plus carboplatin or cisplatin (PP) for first-line treatment of non-squamous advanced non-small cell lung cancer (NSCLC) met its co-primary progression-free survival (PFS) endpoint at the primary analysis in the intention-to-treat (ITT) population. Although the co-primary overall survival (OS) endpoint was not met, numerical OS improvement favoring APP over PP was observed at the final analysis. We report primary results for Chinese patients in IMpower132.

Methods: Treatment-naive Chinese patients with non-squamous stage IV EGFR/ALK mutation-negative NSCLC were randomized 1:1 to receive 4 or 6 cycles of APP or PP, followed by maintenance atezolizumab plus pemetrexed or pemetrexed. Co-primary endpoints were investigator-assessed PFS and OS.

Results: The ITT population included 163 Chinese patients (82 in the APP arm and 81 in the PP arm). At data cutoff (median follow-up, 11.7 months), the median PFS in the APP and PP arms was 8.3 and 5.8 months, respectively; the unstratified hazard ratio (HR) was 0.73 (95% CI: 0.50, 1.08). At the interim OS analysis, median OS was not estimable in either arm; the unstratified HR was 0.70 (95% CI: 0.40, 1.24). No new safety signals were observed.

Conclusion: Among Chinese patients in IMpower132, PFS benefit was seen with APP versus PP. Though interim OS data were immature, there was a trend toward OS benefit favoring APP versus PP. The safety profile of the APP was consistent with the known risks of the individual treatment components.

Clinicaltrials: gov: NCT02657434.

Keywords: China; PD-L1 inhibitor; PD-L1 protein; chemotherapy; non-small cell lung cancer.

Conflict of interest statement

Dr Lu reports grants or contracts from AstraZeneca Pharmaceuticals LP, Hutchison MediPharma, Bristol Myers Squibb Company, Jiangsu Hengrui Medicine Co Ltd, Beigene, F. Hoffmann‐La Roche Ltd, and Jiangsu Hansoh Pharmaceutical Co. Ltd; consulting fees from AstraZeneca Pharmaceuticals LP, Pfizer Inc, Boehringer Ingelheim, Hutchison MediPharma, Simcere Pharmaceutical, ZaiLab Ltd, GenomiCare Biotechnology, Yuhan Corporation, prIME Oncology, Menarini Group, InventisBio Inc Ltd, and F. Hoffmann‐La Roche Ltd; honoraria from AstraZeneca Pharmaceuticals LP, F. Hoffmann‐La Roche Ltd, Jiangsu Hansoh Pharmaceutical Co Ltd, and Jiangsu Hengrui Medicine Co Ltd; and served on an advisory board for F. Hoffmann‐La Roche Ltd, AstraZeneca Pharmaceuticals LP, Xcovery Holding, and Regeneron Pharmaceuticals. Drs Xia, W. Liu, and Shi report employment by F. Hoffmann‐La Roche Ltd. Dr Yi reports employment by Genentech Inc and stock ownership. Drs Wang, Fan, Y. Liu, He, Zhou, Hu, and L. Cao report no conflicts of interest to disclose.

© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Disposition of Chinese patients in IMpower132. One patient from Taiwan from the global enrollment phase was included. APP, atezolizumab plus cisplatin plus pemetrexed; PP, cisplatin plus pemetrexed.
FIGURE 2
FIGURE 2
Investigator‐assessed progression‐free survival (PFS) at the primary PFS analysis. Data cutoff was July 18, 2019. APP, atezolizumab plus cisplatin plus pemetrexed; PP, cisplatin plus pemetrexed.
FIGURE 3
FIGURE 3
Overall survival (OS) at the interim OS analysis. Data cutoff was July 18, 2019. APP, atezolizumab plus cisplatin plus pemetrexed; NE, not evaluable; PP, cisplatin plus pemetrexed.

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