1293P - IMpower150: Updated efficacy analysis in patients with EGFR mutations

Background

Atezolizumab (A) inhibits PD-L1 to restore anti-cancer immunity; bevacizumab (B) may enhance atezolizumab’s efficacy by inhibiting VEGF immunosuppression and promoting T-cell tumour infiltration. In the randomised, Ph III IMpower150 study, first-line treatment (tx) with A + B + carboplatin and paclitaxel (CP) significantly prolonged PFS and OS compared with B + CP in patients (pts) with non-squamous NSCLC, including those with EGFR mutations. Final efficacy analysis of A and/or B with CP in pts with EGFR mutations is reported.

Methods

1202 enrolled pts received A 1200 mg + B 15 mg/kg + C AUC 6 + P 200 mg/m² or ACP or BCP IV q3w for 4 or 6 cycles per investigator decision, followed by q3w maintenance with A + B, A or B, respectively. Co-primary endpoints were OS and investigator-assessed PFS in the ITT–wild-type population (excluded pts with EGFR or ALK alterations). Exploratory analyses included OS in pts with EGFR mutations, pts with sensitising EGFR mutations (exon 19 deletions or L858R mutations) and pts with sensitising EGFR mutations who received prior tyrosine kinase inhibitors (TKIs).

Results

Median follow-up was 39.3 mo in the ITT population (data cutoff: 13 Sept 2019); 123 pts had EGFR mutations, including 91 with a sensitising mutation. Baseline characteristics of pts with EGFR mutations across arms were similar to those in the ITT population. OS was improved with ABCP vs BCP in pts with sensitising EGFR mutations (HR, 0.60 [95% CI: 0.31, 1.14]). Survival benefit was not observed with ACP vs BCP across EGFR mutation subgroups (Table). Results of additional efficacy analyses (PFS, ORR, DOR) and safety will also be presented. Table: 1293P

Conclusions

With ≈ 20 additional months of follow-up, ABCP continued to show an OS benefit vs BCP in pts with sensitising EGFR mutations, including those who had prior tx failure with TKIs. The ABCP regimen may represent a new option for pts with sensitising EGFR mutations for whom TKIs have failed.

Clinical trial identification

NCT02366143.

Editorial acknowledgement

Medical writing assistance for this abstract was provided by Kia C. E. Walcott, PhD, of Health Interactions.

Legal entity responsible for the study

F. Hoffmann-La Roche, Ltd.

Funding

F. Hoffmann-La Roche, Ltd.

Disclosure

M. Reck: Honoraria (self), Advisory/Consultancy, Lecture: AbbVie; Honoraria (self), Advisory/Consultancy, Lecture: Amgen; Honoraria (self), Advisory/Consultancy, Lecture: AstraZeneca; Honoraria (self), Advisory/Consultancy, Lecture: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Lecture: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Lecture: Eli Lilly; Honoraria (self), Advisory/Consultancy, Lecture: Merck; Honoraria (self), Advisory/Consultancy, Lecture: Merck & Co.; Honoraria (self), Advisory/Consultancy, Lecture: Novartis; Honoraria (self), Advisory/Consultancy, Lecture: Pfizer; Honoraria (self), Advisory/Consultancy, Lecture: Roche; Honoraria (self), Advisory/Consultancy, Lecture: Samsung. T. Mok: Speaker Bureau/Expert testimony, Research grant/Funding (institution), Shareholder/Stockholder/Stock options, Personal Fees, Ad Board, Stock Opton as Non-Executive Director: AstraZeneca; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: Roche/Genentech; Speaker Bureau/Expert testimony, Personal Fees and Ad Board: Eli Lilly; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: BMS; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: Boehringer Ingelheim; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: Novartis; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: MSD; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees and Ad Board: Pfizer; Advisory/Consultancy, Personal Fees, Ad Board: Merck Serono; Research grant/Funding (institution), Personal Fees, Ad Board: Clovis Oncology; Advisory/Consultancy, Personal Fees, Ad Board: Vertex; Research grant/Funding (institution), Personal Fees and Ad Board: SFJ Pharmaceuticals; Advisory/Consultancy, Personal Fees, Ad Board: ACEA Biosciences; Advisory/Consultancy, Non-remunerated activity/ies, Non-financial Support: geneDecode; Advisory/Consultancy, Personal Fees, Ad Board: Oncogenex; Advisory/Consultancy, Personal Fees, Ad Board: Celgene; Advisory/Consultancy, Personal Fees, Ad Board: Ignyta Inc.; Speaker Bureau/Expert testimony, Personal Fees: Taiho; Research grant/Funding (institution): Eisai; Advisory/Consultancy, Personal Fees, Ad Board: Fishawack Facilitate Ltd; Speaker Bureau/Expert testimony, Grant, Personal Fees, Ad Board: Takeda; Advisory/Consultancy, Personal Fees, Ad Board: Janssen; Shareholder/Stockholder/Stock options, Stock Option as Non-Executive Director, Personal Fees, Ad Board, Other: HutchisonChiMed; Research grant/Funding (institution): XCovery; Advisory/Consultancy, Personal Fees, Ad Board: OrigiMed; Advisory/Consultancy, Personal Fees, Ad Board: Hengrui Therapeutics; Advisory/Consultancy, Personal Fees, Ad Board: Sanofi-Aventis R&D; Advisory/Consultancy, Personal Fees, Ad Board: Yuhan Corporation; Shareholder/Stockholder/Stock options, Stock Option as Director, Other: Sanomics; Shareholder/Stockholder/Stock options, Other: Loxo-Oncology; Speaker Bureau/Expert testimony, Personal Fees: Amoy Diagnostics Co., Ltd. M.A. Socinski: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Genentech; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): AstraZeneca; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Merck; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Guardant; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Bayer; Research grant/Funding (institution): Novartis. R.M. Jotte: Speaker Bureau/Expert testimony: Bristol-Myers Squibb; Speaker Bureau/Expert testimony: Roche/Genentech. D.W-T. Lim: Honoraria (institution): AstraZeneca; Travel/Accommodation/Expenses: Taiho; Honoraria (institution): Merck; Honoraria (institution): Pfizer; Research grant/Funding (institution): BMS; Shareholder/Stockholder/Stock options: Biolidics. F. Cappuzzo: Advisory/Consultancy: Roche; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: BMS; Advisory/Consultancy: MSD; Advisory/Consultancy: Takeda; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Lilly; Advisory/Consultancy: Bayer. F.J. Orlandi: Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): AstraZeneca; Advisory/Consultancy, Research grant/Funding (institution): Merck & Co.; Research grant/Funding (institution): Amgen; Research grant/Funding (institution): Celltrion; Advisory/Consultancy: BMS; Research grant/Funding (institution), Non-remunerated activity/ies: Novartis; Research grant/Funding (institution): MabXience; Research grant/Funding (institution): Sanofi. N. Nogami: Honoraria (self): Merck & Co.; Honoraria (self): AstraZeneca; Honoraria (self): Pfizer; Honoraria (self): BMS; Honoraria (self): Ono Pharmaceuticals; Honoraria (self): Kyowa Hakko Kirin; Honoraria (self): Taiho; Honoraria (self): Chugai Pharmaceuticals; Honoraria (self): Eli Lilly Japan; Honoraria (self): Boehringer Ingelheim. D. Rodriguez-Abreu: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses, Lectures: Roche; Honoraria (self), Advisory/Consultancy, Lectures: AstraZeneca; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses, Lectures and Grants: BMS; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses, Lectures: MSD; Honoraria (self), Advisory/Consultancy, Lectures: Eli Lilly; Honoraria (self), Advisory/Consultancy, Lectures: Pfizer; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses, Lectures: Novartis. D. Moro-Sibilot: Honoraria (self): Eli Lilly; Honoraria (self): Roche; Honoraria (self): BMS; Honoraria (self): Merck & Co.; Honoraria (self): AstraZeneca; Honoraria (self): AbbVie; Honoraria (self): Amgen; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Takeda. F. Barlesi: Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: AstraZeneca; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: Bayer; Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: BMS; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: Boehringer Ingelheim; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: Eli Lilly Oncology; Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: Roche; Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: Novartis; Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: Merck; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: MSD; Non-remunerated activity/ies, Personal Financial Interest, Institutional Financial Interest, Non-Financial Interest: Pierre Fabre; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: Pfizer; Research grant/Funding (institution), Personal Financial Interest, Institutional Financial Interest: Takeda; Research grant/Funding (institution), Institutional Financial Interest: AbbVie; Research grant/Funding (institution), Institutional Financial Interest: ACEA; Research grant/Funding (institution), Institutional Financial Interest: Eisai; Research grant/Funding (institution), Institutional Financial Interest: Amgen; Research grant/Funding (institution), Institutional Financial Interest: Genentech; Research grant/Funding (institution), Institutional Financial Interest: Ipsen; Research grant/Funding (institution), Institutional Financial Interest: Ignyta; Research grant/Funding (institution), Institutional Financial Interest: Innate Pharma; Research grant/Funding (institution), Institutional Financial Interest: Loxo; Research grant/Funding (institution), Institutional Financial Interest: MedImmune; Research grant/Funding (institution), Institutional Financial Interest: Sanofi-Aventis. G. Finley: Advisory/Consultancy, 4/13/20: Bayer; Advisory/Consultancy, Travel/Accommodation/Expenses, 9/15/18: Roche; Speaker Bureau/Expert testimony, 11/29/18: BMS; Advisory/Consultancy, 2/25/20: Secura Bio. G. Shankar: Full/Part-time employment: Genentech/Roche; Shareholder/Stockholder/Stock options: Exelixis. W. Yu: Full/Part-time employment: Genentech; Shareholder/Stockholder/Stock options: Roche. D. Merritt: Full/Part-time employment: Roche. M. Nishio: Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Ono Pharmaceutical; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: BMS; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Pfizer; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Chugai Pharmaceutical; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Eli Lilly; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Taiho Pharmaceutical; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: AstraZeneca; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Boehringer Ingelheim; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: MSD; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Grants and Personal Fees: Novartis; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Personal Fees: Sankyo Healthcare; Research grant/Funding (institution), Personal Fees: Merck Serono; Research grant/Funding (institution), Grants: Astellas. All other authors have declared no conflicts of interest.