Results presented from the Phase III IMpower133 study and extension trial IMbrella A, show Roche’s Tecentriq (atezolizumab), in combination with chemotherapy, demonstrates a potential long-term overall survival (OS) benefit as first-line treatment for extensive-stage small cell lung cancer (ES-SCLC).
As presented at the IASLC 2023 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer, these are the first reported five-year survival outcomes for people who have received first-line cancer immunotherapy and chemotherapy. Data from IMbrella A and IMpower133 represent the longest survival follow-up data ever reported for a cancer immunotherapy combination in ES-SCLC.
At this five-year OS landmark in IMpower133/IMbrella A, 12 per cent of patients receiving Tecentriq were still alive, demonstrating the potential for a durable survival benefit with Tecentriq plus chemotherapy.1 Historical data of platinum-etoposide chemotherapy, which was the standard first-line treatment for ES-SCLC for several decades, show a five-year OS rate of approximately two per cent.2,3
These results build on the previously reported IMpower133 study. The primary results reported in June 2018 showed that Tecentriq plus chemotherapy helped people live significantly longer compared with chemotherapy alone (median OS=12.3 versus 10.3 months; hazard ratio [HR]=0.70, 95 per cent CI: 0.54-0.91; p=0.0069). These findings were the first clinically meaningful advance in the treatment of ES-SCLC in more than twenty years.4
“The results of IMbrella A and IMpower133 represent the longest survival follow-up reported to date for people with ES-SCLC who have received cancer immunotherapy. The five-year survival rate of 12 per cent is an important landmark for patients with ES-SCLC who have historically had poor outcomes with a five-year survival rate of approximately two per cent,” said Dr Stephen Liu, Associate Professor of Medicine, Director of Thoracic Oncology and Head of Developmental Therapeutics at the Lombardi Comprehensive Cancer Center, Georgetown University.
Safety data for Tecentriq were consistent with the known safety profile and no new safety signals were identified.
Following the primary results of IMpower133, Tecentriq plus chemotherapy became the first cancer immunotherapy combination approved for ES-SCLC in more than 100 countries and reimbursed in more than 30 countries. The Tecentriq combination has been adopted as a standard of care in multiple clinical practice guidelines globally, including in the ESMO Clinical Practice Guidelines.5
References
[1] Liu SV, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at WCLC 2023. Abstract #OA01.04.
[2] Zhang and Cheng. Immunotherapy for extensive-stage small-cell lung cancer: current landscape and future perspectives. Front Oncol. 2023;12:1142081.
[3] Arriola et al. Prognostic Value of Clinical Staging According to TNM in Patients With SCLC: A Real-World Surveillance Epidemiology and End-Results Database Analysis. JTO Clin Res Rep. 2021;3:100266.
[4] Horn L et al. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med 2018;379: 2220–2229.
[5] Annals of Oncology. Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. https://www.annalsofoncology.org/article/S0923-7534(21)01113-3/fulltext. Last accessed: August 2023.
[6] Clinical Trials.gov.A Study of Carboplatin Plus Etoposide With or Without Atezolizumab in Participants With Untreated Extensive-Stage (ES) Small Cell Lung Cancer (SCLC) (IMpower133). Available from: https://classic.clinicaltrials.gov/ct2/show/NCT02763579. Last accessed: August 2023.
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[9] American Cancer Society. Key Statistics for Lung Cancer. Available from: https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html. Last accessed: August 2023.
[10] Alvarado-Luna and Morales-Espinosa. Treatment for small cell lung cancer, where are we now?—a review. Transl Lung Cancer Res. 2016;5(1):26-38.
[11] National Cancer Institute. Available from: https://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq. Last accessed: August 2023.