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Poster session 20

1450P - Addition of bevacizumab to first-line chemoimmunotherapy in NSCLC with liver metastases


21 Oct 2023


Poster session 20


Clinical Research;  Tumour Immunology;  Immunotherapy

Tumour Site

Non-Small Cell Lung Cancer


Matthieu Roulleaux Dugage


Annals of Oncology (2023) 34 (suppl_2): S755-S851. 10.1016/S0923-7534(23)01943-9


M. Roulleaux Dugage1, M. Tagliamento2, T. Gorria3, A. Rochand1, L. Garcin1, S. Oudard1, C. Thibault1, V.M. Albarran Artahona3, J.C. Laguna Montes3, I. Nalda Ariza4, F.J. Muñoz i Carrillo3, L. Aguilar4, A. Arcocha3, L. Lupinacci5, C. Teixido6, B. Besse7, L. Mezquita3, E. Auclin8

Author affiliations

  • 1 Medical Oncology Department, HEGP - Hopital Europeen Georges-Pompidou - AP-HP, 75015 - Paris/FR
  • 2 Department Of Medical Oncology, Gustave Roussy - Cancer Campus, 94805 - Villejuif/FR
  • 3 Medical Oncology Department, Hospital Clinic of Barcelona, 08036 - Barcelona/ES
  • 4 Departamento De Oncología Médica, IDIBAPS - Fundació de Recerca Clinic Barcelona - Institut d'Investigacions Biomediques August Pi i Sunyer, 08036 - Barcelona/ES
  • 5 Clinical Oncology Department, Hospital Italiano de Buenos Aires, C1199ABB - Buenos Aires/AR
  • 6 Pathology Department, Hospital Clinic of Barcelona, 08036 - Barcelona/ES
  • 7 Cancer Medicine Department, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 8 Oncology Dept., HEGP - Hopital Europeen Georges-Pompidou - AP-HP, 75015 - Paris/FR


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Abstract 1450P


Liver metastases create a unique immunosuppressive microenvironment in patients with advanced non-small cell lung cancer (aNSCLC) and are associated with poorer outcomes when treated with chemoimmunotherapy, especially in non-squamous (ns-) aNSCLC.


We retrospectively analyzed data from IMpower150 and IMpower130, which included patients with ns-aNSCLC without EGFR/ALK/KRAS alterations, treated with first-line chemotherapy (CT) with/out atezolizumab (CT+IT) and/or bevacizumab (CT+IT+AA, CT+AA). Data was available on the VIVLI platform.


Out of the 1,523 evaluable patients, 20.4% (n=311), 46.4% (n=707), 19.7% (n=300), and 13.4% (n=205) received CT+IT+AA, CT+IT, CT+AA, and CT, respectively. 13.9% (n=212) of the patients had liver metastases (LM). LM were associated with lower serum albumin and higher lactate dehydrogenase levels, a greater number of metastatic sites (all p<0.001) and poor outcomes across all treatment regimens except for patients treated with upfront CT+IT+AA (Table). In the overall population, CT+IT+AA achieved longer progression-free survival (HR for PFS: 0.74, p<0.001) but not overall survival (HR for OS: 0.91, p=0.38) compared to CT+IT. Of all included variables (age, smoking status, Lung Immune Prognostic Index (LIPI), albumin levels, ECOG performance status, and number of metastatic sites), only LM+ patients yielded substantial OS benefit of CT+IT+AA vs. CT+IT (HR for PFS: 0.44, p<0.001; HR for OS: 0.43, p=0.002, Table). No benefit of CT+AA over CT in patients with/out LM was observed. Table: 1450P

Impact of liver metastases on PFS and OS across all regimens and on response to CT+IT +/- AA

Impact of LM across regimens
Regimen HR for OS (LM+ vs. LM-) p-value
CT 1.8 (1.1-2.9) 0.02
CT+AA 2.2 (1.5-3.3) <0.001
CT+IT 2.5 (1.9-3.2) <0.001
CT+IT+AA 1.0 (0.6-1.7) 0.94
Addition of bevacizumab to CT+IT
Overall LM+ patients
PFS n 707 311 103 39
Events 548 210 90 27
mPFS 6.8 (6.0-7.1) 8.3 (7.7-9.9) 4.4 (3.9-5.4) 8.0 (5.7-13.4)
6M-PFS 53.4% 67.0% 28.4% 58.3%
p <0.001 <0.001
OS n 707 311 103 39
Events 336 128 74 16
mOS 18.6 (16.3-20.5) 19.2 (16.8-NR) 8.7 (6.5-11.2) 16.8 (12.9-NA)
12M-OS 63.6% 67.5% 36.7% 65.5%
p 0.35 0.002


LM are associated with poor outcomes in patients with aNSCLC treated with CT, CT+AA and CT+IT but not CT+IT+AA. The addition of bevacizumab to CT+IT improves outcomes (PFS and OS) in patients with liver metastases and helps correct its negative prognostic impact. The presence of liver metastasis may help in guiding treatment selection in first-line aNSCLC.

Clinical trial identification

Impower130: NCT02367781; Impower150: NCT02366143.

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


S. Oudard: Financial Interests, Personal, Advisory Role: AstraZeneca, Astellas, Bayer, BMS, Ipsen, Janssen, Merck, MSD, Novartis, Pfizer, Sanofi; Financial Interests, Personal, Non financial benefits, Travel Accomodations and Expenses: Eisai, Roche; Financial Interests, Personal, Advisory Board: Roche. C. Thibault: Financial Interests, Personal, Advisory Board: Janssen, Astellas, Sanofi, Ipsen, Pfizer, Merck, MSD, BMS, AstraZeneca, AAA, Seagen; Financial Interests, Institutional, Funding: AstraZeneca, Sanofi. V.M. Albarran Artahona: Financial Interests, Invited Speaker: Merck; Financial Interests, Non financial benefits, Travel, accomodations, expenses: Janssen. C. Teixido: Financial Interests, Personal, Invited Speaker: AstraZeneca, Merck Sharp & Dohme, Roche Farma, Diaceutics, Pfizer, Janssen Oncology; Financial Interests, Personal, Advisory Board: AstraZeneca, Novartis; Financial Interests, Institutional, Research Grant: Novartis. B. Besse: Financial Interests, Institutional, Funding: 4D Pharma, AbbVie, Amgen, Aptitude Health, AstraZeneca, BeiGene, Blueprint Medicines, Boehringer Ingelheim, Celgene, Cergentis, Cristal Therapeutics, Daiichi Sankyo, Eli Lilly, GSK, Janssen, Onxeo, Ose Immunotherapeutics, Pfizer, Roche-Genentech, Sanofi, Takeda, Tolero Pharmaceuticals; Financial Interests, Institutional, Research Grant: Genzyme Corporation, Chugai Pharmaceutical, Eisai, Inivata, Ipsen, Turning Point Therapeutics. L. Mezquita: Financial Interests, Personal, Advisory Board: Takeda, AstraZeneca, Roche; Financial Interests, Personal, Invited Speaker: Roche, BMS, AstraZeneca, Takeda; Financial Interests, Personal, Research Grant, SEOM Beca Retorno 2019 : BI; Financial Interests, Personal, Research Grant, ESMO TR Research Fellowship 2019 : BMS; Financial Interests, Institutional, Research Grant, COVID research Grant: Amgen; Financial Interests, Institutional, Coordinating PI: INIVATA, Stilla. E. Auclin: Financial Interests, Advisory Board: Sanofi, Amgen. All other authors have declared no conflicts of interest.

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