For Previously Treated Non-Small-Cell Lung Cancer, Atezolizumab Seems to Be More Effective than Docetaxel, Report Shows

For Previously Treated Non-Small-Cell Lung Cancer, Atezolizumab Seems to Be More Effective than Docetaxel, Report Shows

A recent Phase 2 clinical trial demonstrated that the cancer treatment atezolizumab was more effective compared to docetaxel at improving survival in patients with previously treated non-small-cell lung cancer (NSCLC).

The research report, Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial, appeared in the prestigious medical journal The Lancet.

People with previously treated NSCLC tend to have poor clinical outcomes. Atezolizumab is an antibody against the anti-programmed death ligand 1 (PD-L1), and it is effective against cancer, including NSCLC in which PD-L1 has been detected in tumors or immune cells infiltrating the tumors.

The team, led by Dr. Louis Fehrenbacher of Kaiser Permanente Medical Center Oncology Department in Vallejo, California, studied atezolizumab and docetaxel in a Phase 2 trial with patients who had been previously treated for their NSCLC. Study participants had PD-L1 detected on their tumor cells and tumor-infiltrating immune cells.

A total of 287 patients from 61 medical centers and oncology practices across 13 countries in Europe and North America participated in the trial. Of those, 142 patients received a minimum one dose of atezolizumab and 135 were given docetaxel.

Survival for atezolizumab was found to be 12.6 months compared to 9.7 months for docetaxel, a statistically significant effect. Patients who had PD-L1 expression in their tumor cells or high T-effector–interferon-γ-associated gene expression were more likely to survive longer on atezolizumab.

Eleven patients in the atezolizumab group discontinued the drug due to side effects compared to 30 in the docetaxel group. One patient in the atezolizumab group died due to drug side effects, compared to three in the docetaxel group.

“Atezolizumab significantly improved survival compared with docetaxel in patients with previously treated NSCLC,” investigators concluded. “Improvement correlated with PD-L1 immunohistochemistry expression on tumor cells and tumor-infiltrating immune cells, suggesting that PD-L1 expression is predictive for atezolizumab benefit. Atezolizumab was well tolerated, with a safety profile distinct from chemotherapy.”

Atezolizumab appears to be a better choice for improving survival compared to docetaxel in this specific patient population with NSCLC and PD-L1 detected on their tumor cells and tumor-infiltrating immune cells. In this study, atezolizumab was better tolerated than docetaxel.

Hoffmann-La Roche/Genentech Inc. provided funding for the study.

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