Atezolizumab

Surgery

Lung cancer

Bevacizumab

Pembrolizumab

Internal medicine

Chemotherapy

Oncology

Medicine

Immunotherapy

Nivolumab

Cancer

Journal of Thoracic Oncology

In the randomized Phase III IMpower150 study, atezolizumab (anti–programmed death-ligand 1 [PD-L1]) + bevacizumab + chemotherapy (Arm B) showed statistically significant and clinically meaningful improvement in both progression-free survival (PFS) and overall survival (OS) over bevacizumab + chemotherapy (Arm C) in patients with first-line (1L) nonsquamous non-small cell lung cancer (NSCLC). The study protocol allowed investigator choice of 4 or 6 chemotherapy cycles. The objective of this exploratory analysis was to assess the impact of chemotherapy cycles on safety and efficacy outcomes. Patients were categorized based on actual chemotherapy cycles received in Arm B. Landmark analysis of PFS was performed to assess the benefit of 4 vs 6 chemotherapy cycles. Sensitivity analyses were performed to adjust the numerically imbalanced baseline factors. A total of 356 patients were randomized in Arm B; 188 patients (53%) were planned to receive 4 cycles, and 168 patients (47%) were planned to receive 6 cycles of chemotherapy. Within these 2 groups, 143 (76%) and 98 patients (58%) completed 4 and 6 chemotherapy cycles, respectively. The demographic and baseline disease characteristics were balanced, except for race (Asian vs other), smoking status, and PD-L1 status (TC3 or IC3 vs other). The landmark PFS analysis showed no difference between patients who completed 4 vs 6 cycles (HR 0.83 [95% CI: 0.59, 1.17). The sensitivity analyses, which adjusted for race, smoking status, or PD-L1, showed comparable results (adjusted HRs of 0.80, 0.85, or 0.91, respectively). In the atezolizumab + bevacizumab + chemotherapy arm, patients who received 4 cycles of chemotherapy appeared to have similar PFS benefit as those who received 6 cycles of chemotherapy. Detailed analyses of varying chemotherapy cycles, safety analyses, and impact on OS will be presented.

P1.01-83 IMpower150: Impact of Chemotherapy Cycles in 1L Metastatic NSCLC in Patients Treated With Atezolizumab + Bevacizumab