Abstract 1358
Background
Atezolizumab, an ani-PD-L1 monoclonal antibody, has been used in the treatment of a wide variety of cancers. Recently, atezolizumab has shown significant antitumor activity against non-small cell lung cancer (NSCLC), the majority of lung cancer which is the leading cause of cancer-related mortality in both sexes. The purpose of our study is to consolidate the efficacy of atezolizumab in combination with chemotherapy for first-line treatment of advanced NSCLC.
Methods
We systematically conducted a comprehensive literature search using PUBMED, MEDLINE, EMBASE databases and meeting abstracts from inception through March 2019. RCTs utilizing first-line atezolizumab chemoimmunotherapy in patients with advanced NSCLC were incorporated. A generic inverse variance method was used to calculate the estimated pooled hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) with 95% confidence interval (CI). Heterogeneity was assessed with Cochran’s Q -statistic. Random effects model was applied.
Results
A total of 2725 patients with advanced NSCLC from four phase III RCTs (IMpower – 130, 131, 132 and 150) were eligible. The study arm used standard chemotherapy regimens in combination with atezolizumab while control arm used only standard chemotherapy regimens. The randomization ratio was 2:1 in IMpower130 study and 1:1 in other studies. IMpower131 study included patients with squamous histology and other studies were employed in patients with non-squamous NSCLC. The pooled HR for PFS was statistically significant at 0.64 (95% CI: 0.59-0.70; P < 0.00001) and the pooled HR for OS was 0.83 (95% CI: 0.75- 0.93; P = 0.0008). In non-squamous NSCLC histology group, the pooled HR for PFS was noted at 0.62 (95% CI: 0.56-0.69; P < 0.00001) and the pooled HR for OS was 0.79 (95% CI: 0.70- 0.90; P = 0.0002).
Conclusions
Our meta-analysis demonstrated that first-line atezolizumab in combination with chemotherapy significantly improved PFS and OS compared to standard chemotherapy in patients with advanced NSCLC, regardless of the histology.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1271 - A large scale prospective concordance study of oncogene driver detection between plasma- and tissue-based NGS analysis in advanced non-small cell lung cancer (NSCLC).
Presenter: Ryo Itotani
Session: Poster Display session 1
Resources:
Abstract
1132 - Biomarker status as a mediator of age-related overall survival (OS) in advanced non-small cell lung cancer (aNSCLC)
Presenter: Aaron Cohen
Session: Poster Display session 1
Resources:
Abstract
1502 - An exploratory analysis of on-treatment ctDNA measurement as a potential surrogate for overall survival for atezolizumab benefit in the OAK Study
Presenter: David Gandara
Session: Poster Display session 1
Resources:
Abstract
3912 - Disease monitoring of EGFR mutation-positive NSCLC patients via circulating tumor DNA
Presenter: Wei Fang Hsu
Session: Poster Display session 1
Resources:
Abstract
3856 - Incidence of T790M in NSCLC patients progressed to gefitinib, erlotinib, and afatinib: a study on circulating tumor DNA
Presenter: Romano Danesi
Session: Poster Display session 1
Resources:
Abstract
1330 - Folate receptor-positive circulating tumor cells as a predictive biomarker for the efficacy of first-line pemetrexed-based therapy in patients with non-squamous non-small cell lung cancer
Presenter: Xiaoxia Chen
Session: Poster Display session 1
Resources:
Abstract
3512 - Carcinoembryonic Antigen of Cerebrospinal Fluid Predict Prognosis of Leptomeningeal Metastasis from Non-Small Cell Lung Cancer
Presenter: Junjie Zhen
Session: Poster Display session 1
Resources:
Abstract
3852 - Liquid biopsy in clinical pratice of Non-Small-Cell-Lung Cancer (NSCLC): a multi-institutional experience
Presenter: Giovanna De Maglio
Session: Poster Display session 1
Resources:
Abstract
1205 - A Phase III Study Comparing SB8, a Proposed Bevacizumab Biosimilar, and Reference Bevacizumab in Patients with Metastatic or Recurrent Non-squamous NSCLC
Presenter: Martin Reck
Session: Poster Display session 1
Resources:
Abstract
2432 - Retrospective comparative study of the efficacy and safety in docetaxel and ramucirumab combination chemotherapy with or without previous immune checkpoint inhibitor treatment.
Presenter: Daijiro Harada
Session: Poster Display session 1
Resources:
Abstract