Comparing the effectiveness and safety outcomes of atezolizumab alone or with chemotherapy for the treatment of advanced non-small cell lung cancer.

This study compared the effectiveness and safety outcomes of atezolizumab (Tecentriq) alone or with chemotherapy (CT) for the treatment of patients with advanced non-small-cell lung cancer (NSCLC). The data showed that atezolizumab alone might be a better treatment option than atezolizumab plus CT for these patients.

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. NSCLC is responsible for around 85% of all lung cancer diagnoses. Standard treatment for advanced NSCLC involves surgical removal of solid tumors, CT, and radiotherapy. Despite current treatment options improving survival rates, advanced NSCLC can be difficult to treat.

Immunotherapy has been found to be effective in advanced NSCLC. PD-L1 is a protein that can be found in high numbers on cancer cells. It shuts down the immune system so that cancer cells can grow and spread without detection. Atezolizumab is an immunotherapy that targets PD-L1. Blocking PD-L1 restores the capacity of the immune system to attack and kill cancer cells.

Atezolizumab as a first-line treatment has been found to significantly improve the outcomes of patients with advanced NSCLC. However, there are very few studies investigating the effectiveness and safety outcomes of atezolizumab plus CT versus atezolizumab alone in patients with advanced NSCLC according to PD-L1 expression (presence on cancer cells).

This study analyzed 5 other studies on 616 patients with NSCLC. Patients were divided into 3 groups. Group 1 included patients who received atezolizumab plus CT. Group 2 included patients who only received CT. Group 3 included patients who received atezolizumab alone. The average follow-up time ranged from 15.7 months to 28.4 months.

Patients in group 1 were 35% more likely to have a better overall survival than group 2. Patients in group 3 were 41% more likely to have a better overall survival than group 2.

Patients in group 1 were 58% more likely to have a better survival without cancer progression than group 2. Patients in group 3 were 37% more likely to have a better survival without cancer progression than group 2.

Patients in group 1 were 49% more likely to respond better to treatment than group 2. Patients in group 3 were 33% more likely to respond better to treatment than group 2.

Patients who received atezolizumab plus CT had similar overall survival and response to treatment when compared to patients who received atezolizumab alone.

However, patients treated with atezolizumab plus CT were 4.23 times more likely to experience severe side effects than those treated with atezolizumab alone.

This study concluded that atezolizumab alone might be a better treatment option than atezolizumab plus CT for patients with NSCLC and high PD-L1 expression.

The sample size was very small. Also, this study did not directly compare atezolizumab plus CT to atezolizumab alone.