In a nutshell
This trial examined whether the immunotherapy atezolizumab (Tecentriq) is more effective than docetaxel (Taxotere) at treating non-small-cell lung cancer that has progressed passed first line treatment. The authors concluded that atezolizumab provided an overall survival benefit compared to docetaxel.
Some background
Docetaxel is the most common chemotherapy to treat NSCLC that has progressed passed previous treatment. Despite its effectiveness, it is associated with several toxic side effects. Current research is focusing on targeted therapies, including therapies that help activate the immune system against cancer cells. PD-L1 inhibitors work by blocking the PD-L1 protein and activating the immune system. One example of this type of treatment is atezolizumab. There is some evidence to suggest this is more effective than docetaxel at treating NSCLC that has progressed following previous treatment.
Methods & findings
The authors aimed to determine whether atezolizumab was more effective than docetaxel. The study included a final total of 1225 patients. They had stage IIIB/IV NSCLC that had progressed following previous chemotherapy treatment.
609 patients in group 1 were treated with atezolizumab and 578 patients in group 2 were treated with docetaxel. The average follow-up was 21 months. By the end of the trial, 569 patients had died. 271 of there were from group 1 and 298 were from group 2.
Overall survival (time from treatment until death from any cause) was measured in 425 patients from each group. The average overall survival for patients in group 1 was 13.8 months compared to 9.6 months for patients in group 2. This improvement was also found for patients with both high and low levels of PD-L1.
15% of all patients in group 1 experienced severe treatment related side effects compared to 43% in group 2. Of the patients who had side effects from group 1, 14% had fatigue, 9% had nausea, 9% had decreased appetite and 8% had physical weakness.
There was 1 treatment related death from docetaxel.
The bottom line
The authors concluded that atezolizumab provided an overall survival benefit compared to docetaxel.
The fine print
This study was funded by F. Hoffmann-La Roche Ltd. and Genentech, Inc., the manufacturers of atezolizumab.
Published By :
Lancet (London, England)
Date :
Dec 12, 2016
