IMpower150: Analysis of efficacy in patients (pts) with liver metastases (mets).

Authors

null

Mark A. Socinski

AdventHealth Cancer Institute, Orlando, FL

Mark A. Socinski , Robert M. Jotte , Federico Cappuzzo , Tony S. K. Mok , Howard West , Makoto Nishio , Vassiliki Papadimitrakopoulou , Francisco J Orlandi , Daniil Stroyakovskiy , Christian A. Thomas , Naoyuki Nogami , Fabrice Barlesi , Anthony Lee , Geetha Shankar , Wei Yu , Marcus Ballinger , Ilze Bara , Alan Sandler , Martin Reck

Organizations

AdventHealth Cancer Institute, Orlando, FL, Rocky Mountain Cancer Centers, Denver, CO, Azienda Unità Sanitaria Locale della Romagna, Ravenna, Italy, Prince of Wales Hospital, Hong Kong, China, Swedish Cancer Institute, Seattle, WA, Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan, The University of Texas MD Anderson Cancer Center, Houston, TX, Instituto Nacional del Torax, Santiago, Chile, Moscow City Oncology Hospital, Moscow, Russian Federation, New England Cancer Specialists, Scarborough, ME, Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France, Genentech, Inc., South San Francisco, CA, LungenClinic, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany

Research Funding

Pharmaceutical/Biotech Company

Background: Atezolizumab (atezo) + bevacizumab (bev) + chemo (carboplatin + paclitaxel [CP]; ABCP) showed improved PFS and OS vs bev + CP (BCP) in pts with chemo-naive NSCLC (IMpower150). Benefit with ABCP vs BCP extended to key subgroups, including pts with baseline (BL) liver mets, which is a poor prognostic factor in metastatic NSCLC. Similar outcomes were not seen with atezo + chemo (IMpower150 [atezo + CP; ACP]; IMpower130; IMpower132), suggesting that the addition of bev to atezo + chemo is important for conferring clinical benefit in these pts. Here we further explore characteristics and responses of pts with BL liver mets in IMpower150. Methods: 1202 ITT pts were randomized 1:1:1 to receive ABCP, ACP or BCP. Doses were: A, 1200 mg; B, 15 mg/kg; C, AUC 6 mg/mL/min; P, 200 mg/m2. Coprimary endpoints were OS and investigator-assessed PFS in ITT–wild-type pts. Exploratory analyses included efficacy and safety in pts with liver mets. Results: The data capture ≥ 20-mo follow-up in ITT pts (data cutoff: Jan 22, 2018). 162 pts had BL liver mets (ABCP, n = 52; ACP; n = 53; BCP, n = 57), with a median of 3 metastatic sites and median BL tumor SLD of 109 mm (range, 10-249). BL characteristics in these pts were generally balanced across study arms. PFS and OS were improved with ABCP vs BCP (Table). Gr 3-4 treatment-related AEs occurred in 52.1%, 36.5% and 54.5% of pts with liver mets in the ABCP, ACP and BCP arms, respectively. Conclusions: ABCP reduced the risk of death in pts with liver mets by 48% vs BCP and may represent an important new treatment option for this population. Clinical trial information: NCT02366143

Presence
of liver mets
mPFS, mo
HR (95% CI)
ABCPACPBCPABCP vs
BCP
ACP vs
BCP
Yes8.25.45.40.410.81
n = 52n = 53n = 57(0.26, 0.62)(0.55, 1.21)
No8.46.97.00.610.90
n = 348n = 349n = 343(0.52, 0.73)(0.77, 1.06)
mOS, moHR (95% CI)
Yes13.38.99.40.520.87
n = 52n = 53n = 57(0.33, 0.82)(0.57, 1.32)
No20.421.017.00.820.84
n = 348n = 349n = 343(0.66, 1.02)(0.68, 1.04)
ORR, %aDifference (95% CI), %
Yes60.826.941.119.7-14.2
n = 51n = 52n = 56(-0.75, 40.18)(-33.65, 5.35)
No55.842.740.115.72.6
n = 346n = 349n = 337(8.03, 23.4)(-5.03, 10.29)
mDOR, moHR (95% CI)
Yes10.75.64.60.390.59
n = 31n = 15n = 23(0.21, 0.73)(0.29, 1.23)
No11.59.26.50.430.52
n = 193n = 149n = 138(0.33, 0.55)(0.40, 0.69)

a Pts with measurable disease at BL

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT02366143

Citation

J Clin Oncol 37, 2019 (suppl; abstr 9012)

DOI

10.1200/JCO.2019.37.15_suppl.9012

Abstract #

9012

Poster Bd #

335

Abstract Disclosures