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Poster Display session

21P - Bevacizumab plus atezolizumab and chemotherapy in NSCLC harbouring EGFR mutation previously treated with EGFR tyrosine kinase inhibitor: The BACH-NET study

Date

31 Mar 2023

Session

Poster Display session

Presenters

Giulia Pasello

Citation

Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.
<article-id>elcc_Ch01

Authors

G. Pasello1, M. Lorenzi2, G. Crivellaro3, E. Capelletto4, S. Butticè4, F. Perrone5, M. Tiseo5, V. Scotti6, V. Polo7, A. Favaretto7, M. Montrone8, R. Berardi9, F. Zustovich10, L. Toschi11, A. Bearz12, M. Milella13, S. Frega3, L. Bonanno14, V. Guarneri15

Author affiliations

  • 1 Padova/IT
  • 2 IOV - Istituto Oncologico Veneto IRCCS, Padova/IT
  • 3 Oncology 2 IOV - Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 4 Azienda Ospedaliera Universitaria San Luigi Gonzaga, Orbassano/IT
  • 5 Medical Oncology Unit, University Hospital of Parma, Parma, Italy, Parma/IT
  • 6 AOUC - Azienda Ospedaliero-Universitaria Careggi, Firenze/IT
  • 7 Ospedale Regionale Ca' Foncello, Treviso/IT
  • 8 IRCCS Istituto Tumori "Giovanni Paolo II", Bari/IT
  • 9 Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Ancona", Ancona/IT
  • 10 Ospedale di Belluno, Belluno/IT
  • 11 Istituto Clinico Humanitas, Rozzano/IT
  • 12 Centro di Riferimento Oncologico di Aviano National Cancer Institute, Aviano/IT
  • 13 AOU Integrata di Verona - Ospedale Borgo Roma, Verona/IT
  • 14 Oncology 2 IOV - Istituto Oncologico Veneto IRCCS, Padova/IT
  • 15 IOV - Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT

Resources

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Abstract 21P

Background

Atezolizumab (A)/Bevacizumab(B)/Carboplatin/Paclitaxel (CP) has been proposed as a second-line option in EGFR mutant (EGFRm) non-small lung cancer (NSCLC) patients (pts) progressing to EGFR tyrosine kinase inhibitors (TKIs) without druggable resistance targets on the basis of an exploratory analysis of the phase III trial IMpower150. A therapeutic named use program has been open in Italy (June 2019-July 2020), although this regimen has not been approved. A real-world study has been designed in order to acquire more solid data about its feasibility.

Methods

This is a retrospective-prospective observational multicenter study with the primary aim to assess the feasibility of ABCP (rate of ineligible patients/potentially candidates) according to clinicians’ selection criteria in the real-world practice of 11 Italian centres. Secondary endpoints are overall survival (OS), progression free survival (PFS), response rate (RR), disease control rate (DCR), duration of response (DoR), time to treatment failure and discontinuation (TTF and TTD), safety and quality of life (QOL).

Results

We report preliminary data from 80 EGFRm NSCLC pts progressing to TKIs. Overall, twenty-two received the ABCP regimen, with an ineligibility rate of 80%, mostly because of poor performance status (PS) and age. After a median follow-up of 14.2 months (mos), median TTD and TTF of 8.0 and 8.7 mos, respectively, were observed. The RR was 32% and DCR was 82%, with a median DoR of 3.9 mos. The median PFS was 5.7 mos and the OS was 16.2 mos. Adverse events (AEs) occurred in 15 (68%) patients: 6 (27%) G3/G4, 1 (5%) G5 (pneumonia). The most frequent AEs were: fatigue (36.4%), hypertension (18.2%), non-febrile neutropenia (18.2%). The QOL assessment through EORTC, QLQ-C30 e QLQ-LC13 scales, showed a worsening of the global health, the person's ability and the symptoms after the first or second cycle of treatment.

Conclusions

This observational study included a more representative sample of patients of the clinical practice, (poor PS; comorbidities). The high rate of ineligibility confirms this combination regimen as not feasible for most patient. Median OS, PFS and the incidence of AEs are lower than in the IMpower150 trial.

Legal entity responsible for the study

University of Padova.

Funding

University of Padova and Istituto Oncologico Veneto IRCCS.

Disclosure

All authors have declared no conflicts of interest.

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