Abstract 3P
Background
Metastatic NSCLC is a leading cause of cancer death globally. Although implementation of immunotherapies has improved overall survival (OS), certain subgroups such as never smokers appear to derive less benefit from immunotherapy monotherapy. This analysis of the IMpower110 trial explores the efficacy of atezolizumab compared to chemotherapy in the PD-L1 high (TC≥50%/IC≥10%) patients by smoking status, as well as the achievement of long-term benefit (LTB) in the ever-smoking population.
Methods
We analyzed baseline characteristics and efficacy outcomes (OS and progression-free survival (PFS)) in the aforementioned population and clinically relevant subgroups. Kaplan-Meier curves and forest plots are presented. We characterized the LTB population, defined as patients who lived ≥2 years since randomization. We performed Chi-square tests to assess factors associated with LTB.
Results
In the PD-L1 high population the OS HR was 1.80 (0.71-4.52) for never smokers and 0.71 (0.49-1.04) for ever-smokers. The following results refer to the ever-smoking, PD-L1 high population, which consists of 181 patients (88.3% of all patients with high PD-L1 expression by SP142): The median follow-up was 30.6 months (mo). A median OS of 23.13 mo in the atezolizumab arm was observed compared to 11.04 mo with chemotherapy (HR= 0.71; 95% CI: 0.49-1.04; p=0.079). Likewise, median PFS favored atezolizumab with 8.34 vs 4.88 mo (HR= 0.56; 95% CI: 0.40-0.78; p<0.001). LTB was achieved by 46% (n=45) of patients who received atezolizumab and 33% (n=27) of patients who received chemotherapy. In the atezolizumab arm, clinical factors such as ECOG, liver metastases and race were significantly associated with LTB.
Conclusions
This exploratory analysis of the IMpower110 study reiterates the difference in the efficacy of monotherapy immunotherapy compared to chemotherapy based on smoking status. Atezolizumab is associated with better efficacy outcomes and provided LTB in a higher number of patients compared to chemotherapy in the ever-smoking PD-L1 high population.
Legal entity responsible for the study
Roche Pharma.
Funding
Roche Pharma.
Disclosure
L. Paz-Ares: Financial Interests, Personal, Advisory Board, Speaker fees: Roche, MSD, BMS, AZ, Lilly, PharmaMar, BeiGene, Daichii, Medscape, PER; Financial Interests, Personal, Advisory Board: Merck Serono, Pfizer, Bayer, Amgen, Janssen, GSK, Novartis, Takeda, Sanofi, Mirati; Financial Interests, Personal, Other, Board member: Genomica, Altum sequencing; Financial Interests, Personal, Member of Board of Directors, Board member: Stab Therapeutics; Financial Interests, Institutional, Coordinating PI: BMS, Janssen-Cilag international NV, Novartis, Roche, Sanofi, Tesaro, Alkermes, Lilly, Takeda, Pfizer, PharmaMar, Daiichi Sankyo, AstraZeneca, Merck Sharp & Dohme corp; Financial Interests, Personal, Coordinating PI: Amgen; Financial Interests, Personal, Other, Foundation Board Member: AECC; Financial Interests, Personal, Other, Member: AACR, ASCO, ESMO; Financial Interests, Personal, Other, President: ASEICA (Spanish Association of Cancer Research); Financial Interests, Personal, Other, Foundation president: ONCOSUR; Financial Interests, Personal, Other, member: Small Lung Cancer Group. M.R. García-Campelo: Financial Interests, Personal, Speaker, Consultant, Advisor, travel/accomodation/expenses: Roche, Merck, BMS, AstraZeneca, Lilly, Pfizer; Financial Interests, Personal, Speaker, Consultant, Advisor: PharmaMar, Bayer, AbbVie, GSK, Boehringer. M.D. Isla Casado: Financial Interests, Personal, Speaker, Consultant, Advisor, travel/accomodation/expenses: Roche, Merck, BMS, AstraZeneca, Lilly, Pfizer, Amgen, Boehringer; Financial Interests, Personal, Research Grant: BMS, Roche, AstraZeneca, Lilly; Financial Interests, Personal, Speaker, Consultant, Advisor: Bayer; Financial Interests, Personal, Advisory Role: AbbVie, Takeda. E. Carcereny: Financial Interests, Personal, Advisory Role, travel/accomodation/expenses: Roche, Bristol Myers Squibb, MSD, Takeda; Financial Interests, Personal, Advisory Role: AstraZeneca, Boehringer, Novartis; Financial Interests, Personal, Other, travel/accomodation/expenses: Pfizer. D. Rodriguez Abreu: Financial Interests, Personal, Speaker, Consultant, Advisor, travel/accomodation/expenses: Roche, Merck, BMS, AstraZeneca; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Speaker, Consultant, Advisor: Boehringer, Takeda. J.J. Garcia Gonzalez: Financial Interests, Personal, Speaker, Consultant, Advisor, travel/accomodation/expenses: Roche; Financial Interests, Personal, Advisory Role, travel/accomodation/expenses: Merck, BMS, Boehringer; Financial Interests, Personal, Advisory Role: AstraZeneca, Lilly, Pfizer. D. Perez Parente: N. Gonzalez Mancha, E. Vilas,P. Ruiz Gracia, A. Greco: Financial Interests, Institutional, Member, employee: Roche Pharma Spain. D.R. Spigel: Consulting or Advisory Role: Genentech/Roche (Inst), Novartis (Inst), Bristol Myers Squibb (Inst), AstraZeneca (Inst), GSK (Inst), Amgen (Inst), Ipsen (Inst), Jazz Pharmaceuticals (Inst), Sanofi/Aventis (Inst), Novocure (Inst), Regeneron (Inst), Lilly (Inst), AbbVie (Inst), BeiGene (Inst), Lyell (Inst), Monte Rosa Therapeutics (Inst). Research Funding: Genentech/Roche (Inst), Novartis (Inst), Celgene (Inst), Bristol Myers Squibb (Inst), Lilly (Inst), AstraZeneca (Inst), University of Texas Southwestern Medical Center-Simmons Cancer Center (Inst), Merck (Inst), G1 Therapeutics (Inst), Neon Therapeutics (Inst), Takeda (Inst), Nektar (Inst), Celldex (Inst), Clovis Oncology (Inst), Daiichi Sankyo (Inst), EMD Serono (Inst), Astellas Pharma (Inst), GRAIL (Inst), Transgene (Inst), Aeglea Biotherapeutics (Inst), Ipsen (Inst), BIND Therapeutics (Inst), Eisai (Inst), ImClone Systems (Inst), Immunogen (Inst), Janssen Oncology (Inst), MedImmune (Inst), Molecular Partners (Inst), Agios (Inst), GSK (Inst), Tesaro (Inst), Cyteir (Inst), Apollomics (Inst), Novocure (Inst), Elevation Oncology (Inst), Calithera Biosciences (Inst), Arcus Biosciences (Inst), Arrys Therapeutics (Inst), Bayer (Inst), BeiGene (Inst), BioNTech (Inst), Blueprint Medicines (Inst), Boehringer Ingelheim (Inst), Hutchison MediPharma (Inst), Incyte (Inst), Kronos Bio (Inst), Loxo Oncology (Inst), Macrogenics (Inst), Oncologie (Inst), Pfizer (Inst), PTC Therapeutics (Inst), PureTech (Inst), Razor Genomics (Inst), Repare Therapeutics (Inst), Rgenix (Inst), Tizona Therapeutics Inc (Inst), Verastem (Inst), AbbVie (Inst), Amgen (Inst), AnHeart Therapeutics (Inst), Ascendis Pharma (Inst), Asher Biotherapeutics (Inst), Ellipses Pharma (Inst), Endeavor (Inst), Erasca (Inst), Evelo Biosciences (Inst), Faeth Therapeutics (Inst), Foundation Bio (Inst), FujiFilm Pharmaceuticals (Inst), Gilead Sciences (Inst), Janux Therapeutics (Inst), Jazz Pharmaceuticals (Inst), Lyell Immunopharma (Inst), Millennium Pharmaceuticals (Inst), Moderna (Inst), Monte Rosa Therapeutics (Inst), Peloton Therapeutics (Inst), SeaGen (Inst), Shenzhen Chipscreen Biosciences (Inst), Strata Oncology (Inst), Stemline Therapeutics (Inst), Synthekine (Inst), Taiho (Inst), Tango Therapeutics (Inst), Tarveda (Inst), and Zai Laboratory (Inst). F. de Marinis: Consulting or Advisory Role: AstraZeneca, MSD Oncology, Bristol Myers Squibb, Roche/Genentech, Pfizer, Novartis, Takeda. J. Jassem: Consulting or Advisory Role: AstraZeneca, Amgen, Boehringer Ingelheim.
Resources from the same session
16P - Exosomal PD-L1 and lactate predict clinical outcomes of PD-1 blockade combined with chemotherapy in advanced-stage gastric and gastroesophageal junction adenocarcinoma
Presenter: Yongshun Chen
Session: Poster Display
17P - Spatial Characteristics Associated with the Chemo and Immuno-treatment Response of Gastric Cancer Revealed by Multi-omics Analysis
Presenter: Gang Che
Session: Poster Display
18P - Association of DNA methylation profiles with pathologic complete response in early triple negative breast cancer patients receiving neoadjuvant chemoimmunotherapy
Presenter: Angelika Starzer
Session: Poster Display
19P - The prognostic value of soluble CD73 in advanced triple-negative breast cancer: an exploratory analysis of the SYNERGY trial
Presenter: Denis Zoë
Session: Poster Display
21P - Mass cytometry reveals a population of exhausted CD8+ T cells associated with durvalumab/tremelimumab/vinorelbine efficacy in advanced cervical cancer (iMOVIE).
Presenter: Alexandre Bertucci
Session: Poster Display
22P - Predictive value of Tertiary Lymphoid Structure in patients with mismatch repair deficient advanced/ recurrent endometrial cancer treated with Dostarlimab.
Presenter: Maria Kfoury
Session: Poster Display
23P - Circulating immune cells and activity of immune checkpoint inhibitors in metastatic renal cell carcinoma
Presenter: Ronan Flippot
Session: Poster Display
24P - Chromosome 3p-related gene alterations (GA) as biomarkers for immunocombinations in metastatic renal cell carcinoma (mRCC): a hypothesis-generating analysis
Presenter: Matteo Rosellini
Session: Poster Display