IMpower150 final overall survival analyses for atezolizumab plus bevacizumab and chemotherapy in first-line metastatic nonsquamous non-small cell lung cancer

Science and Research

INTRODUCTION: We report final overall survival (OS) analyses of atezolizumab-carboplatin-paclitaxel (ACP [experimental arm]) and OS data with ≈ 39.8 months of median follow-up with atezolizumab-bevacizumab-carboplatin-paclitaxel (ABCP) versus bevacizumab-carboplatin-paclitaxel (BCP) in chemotherapy-naive patients with metastatic nonsquamous non-small cell lung cancer (NSCLC) in the Phase III IMpower150 study (NCT02366143). METHODS: In this randomized, open-label study (N = 1202), coprimary endpoints included investigator-assessed progression-free survival and OS in intention-to-treat (ITT) wild-type (WT; no EGFR or ALK alterations) patients. Secondary and exploratory endpoints included OS in ITT and PD-L1 subgroups defined by the VENTANA SP142 and SP263 immunohistochemistry assays. RESULTS: At the final analysis with ACP vs BCP (data cutoff: September 13, 2019; minimum follow-up: 32.4 months), ACP showed numerical, but not statistically significant, improvements in OS (ITT-WT: median OS [mOS] 19.0 vs 14.7 months; hazard ratio [HR] 0.84; 95% CI, 0.71-1.00). OS benefit was sustained with ABCP vs BCP (ITT-WT: 19.5 vs 14.7 months; HR 0.80; 95% CI, 0.67-0.95). Exploratory analyses in the SP142-defined PD-L1 subgroups showed longer median OS with ABCP and ACP vs BCP in PD-L1-high and PD-L1-positive subgroups; in the PD-L1-negative subgroups, median OS was similar with ACP and ABCP vs BCP. Safety was consistent with that in earlier analyses (data cutoff: Jan 22, 2018). CONCLUSIONS: At the final IMpower150 OS analysis, ACP showed numerically, but not statistically significant, OS improvement vs BCP. Updated data with an additional 20 months of follow-up showed continued OS improvement with ABCP vs BCP in all patients.