Abstract 29P
Background
IMpower150 study showed that the combination of immune chemotherapy plus bevacizumab provided a favorable efficacy for patients with non-squamous lung cancer harboring EGFR mutations. Although its effectiveness has been approved, little is known about the clinical outcome of the combination therapy in routine practice, especially for the Asian population with high EGFR mutation incidence. The current study aimed to explore the clinical efficacy and prognosis of combinational treatment with atezolizumab, bevacizumab, and platinum-based chemotherapy in patients with EGFR-mutated lung cancer who progressed with standard EGFR-targeted therapies.
Methods
From April 2019 to June 2022, we retrospectively collected patient-level data on atezolizumab-bevacizumab-chemotherapy combination treatment in NSCLC patients with EGFR mutations after the failure of EGFR TKIs at the National Taiwan University Hospital. The patient's clinical characteristics and treatment outcomes were recorded.
Results
We collected 36 patients, including 28 females and 35 non-smokers. The median age was 59.5 (range 40.4–81.3) years. EGFR mutation types included 13 deletion in exon19, 19 L858R, and 4 uncommon types. Before the combination therapy, 24 (66.7%) patients and 11 (30.6%) patients have taken osimertinib and anti-angiogenesis, respectively. PD-L1 expression was ≧ 1% in 19 (52.8%) patients. The treatment outcomes included a response rate of 44.4% (16 of 36), median progression-free survival (mPFS) of 7.8 months, and median overall survival of 16.7 months. Patients with PD-L1 expression ≧ 1% have a loner mPFS than those with PD-L1 expression <1% or unknown (10.6 months vs. 2.5 months vs. 7.8 months; p < 0.001). There were no significant differences in response rates and PFS between patients with and without malignant pleural effusion, liver, or brain metastasis.
Conclusions
The combination treatment of atezolizumab, bevacizumab, pemetrexed, and cisplatin/carboplatin provided favorable efficacy in EGFR mutation-positive NSCLC after TKI failure, and higher PD-L1 expression (≧ 1%) was associated with longer PFS.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Wu: Financial Interests, Personal, Invited Speaker: AstraZeneca, Boehringer Ingelheim, Merck Sharp & Dohme, Bristol-Myers Squibb, Pfizer, Novartis, Eli Lilly, Roche. C. Ho: Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim, AstraZeneca, Eli Lilly, Amgen, Roche/Genentech, Merck Sharp & Dohme, Pfizer, Novartis, Bristol-Myers Squibb, Ono Pharmaceuticals. W. Liao: Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche, Boehringer Ingelheim, Eli Lilly, Pfizer, Merck Sharp & Dohme, Novartis, Bristol-Myers Squibb, Chugai Pharma Taiwan. J.C. Yang: Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim, AstraZeneca, Roche/Genentech, Pfizer, Novartis, Merck Sharp & Dohme, Merck Serono, Clovis Oncology, Bayer; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim, AstraZeneca, Roche/Genentech, Pfizer, Novartis, Merck Sharp & Dohme, Merck Serono, Clovis Oncology, Bayer. J. Shih: Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Ono Pharmaceutical, Chugai Pharmaceutical, Bristol-Myers Squibb; Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Ono Pharmaceutical, Chugai Pharmaceutical, Bristol-Myers Squibb. All other authors have declared no conflicts of interest.