In a nutshell
This study looked at the safety and effectiveness of atezolizumab (Tecentriq) compared to platinum-based chemotherapy for the treatment of advanced lung cancer. They found that atezolizumab improved survival compared to chemotherapy in these patients.
Lung cancer is classified based on how the tumor cells look under the microscope. Non-small cell lung cancer (NSCLC) the most common type of lung tumor. Patients with metastatic NSCLC, have tumors that have spread to other parts of the body. Platinum-based chemotherapy is a common treatment for these patients.
Some lung tumors produce special proteins that help them to evade the body’s immune system. Programmed cell death ligand 1 (PD-L1) is one of these proteins. It interacts with the immune system and tells the body not to attack the tumor cells. This allows the tumor to hide from the body’s defenses and to survive. There are now targeted immune therapies such as atezolizumab that can block PD-L1 and help the immune system to fight the tumor.
The safety and effectiveness of atezolizumab compared to platinum-based chemotherapy on NSCLC tumors that produce PD-L1.
Methods & findings
This study involved 554 patients with advanced NSCLC, with tumors that produced PD-L1. Participants were divided into 2 groups. Group 1 received immune therapy with atezolizumab. Group 2 received chemotherapy. Patients who had previous chemotherapy were excluded from the study. Participants were followed up for an average of 13.4-15.7 months.
Patients who had high levels of PD-L1 and received atezolizumab survived an average of 7.1 months longer than patients receiving chemotherapy (20.2 months vs. 13.1 months). They also survived on average 8.1 months without any progression of the cancer, compared to 5 months for the chemotherapy group.
In patients with high or medium levels of PD-L1, the average survival for group 1 was 18.2 months vs 14.9 months for group 2. The average time without cancer progression was 7.2 months in group 1 and 5.5 months in group 2 for these patients.
Side effects occurred in 90.2% of group 1 and 94.7% of group 2. 28.3% of the atezolizumab group and 28.5% of the chemotherapy group reported serious complications from the treatment.
The bottom line
This study showed that patients with advanced NSCLC and PD-L1-expressing tumors had longer survival with atezolizumab compared to chemotherapy combinations.
The fine print
This study was funded by the company that produces atezolizumab. This study is still ongoing. Longer-term results are still expected.
Published By :
The New England Journal of Medicine
Oct 01, 2020