An exploratory post-hoc pooled analysis of three phase 3 trials with atezolizumab in patients with stage IV non-small cell lung cancer (NSCLC) – IMpower130, IMpower132, and IMpower150 – shows longer overall survival for patients who experience immune-related adverse events.
Immune-related adverse events have been reported in up to 80% of patients receiving immune checkpoint inhibitor monotherapy and up to 95% of patients receiving immune checkpoint inhibitor combination therapy1. Increasing evidence suggests that the occurrence of immune-related adverse events my be predictive of improved outcomes in cancers such as NSCLC2.
The phase 3 IMpower130 (NCT02367781), IMpower132 (NCT02657434), and IMpower150 (NCT02366143) trials evaluated efficacy and tolerability of atezolizumab in NSCLC3-5. The association between immune-related adverse events an efficacy in these trails was explored in a post-hoc pooled analysis, of which Dr Mark Socinski (AdventHealth Cancer Institute, FL, USA) presented the results6.
A total of 2,503 patients were enrolled in these 3 trials: 1,577 patients were treated with atezolizumab, 926 patients were in the control arms. In the atezolizumab arm, 753 patients experienced an immune-related adverse event, 824 patients were without immune-related adverse events. In the control arm, 289 patients experienced an immune-related adverse event, whereas 637 patients did not.
Median overall survival in the atezolizumab arm was 25.7 months for patients who experienced an immune-related adverse event versus 13.0 months for patients without immune-related adverse events (HR 0.69). In the control arm, median survival was 20.2 months and 12.8 months, respectively (HR 0.82). In the atezolizumab arm, objective response rate was 61.1% in patients who experienced an immune-related adverse event and 37.2% in patients without immune-related adverse events.
1. Jamal S, et al. J Rheumatol. 2020 Feb;47(2):166-175.
2. Zhou X, et al. BMC Med 2020;18: 87.
3. West H, et al. Lancet Oncol 2019; 20: 924-937.
4. Nishio M, et al. J Thorac Oncol 2021; 16: 653-664.
5. Socinski MA, et al. N Engl J Med 2018; 378: 2288-2301.
6. Socinski MA, et al. Pooled analyses of immune-related adverse events (irAEs) and efficacy from the phase 3 trials IMpower130, IMpower132, and IMpower150. ASCO 2021 Virtual Meeting, abstract 9002.