HealthDay News – For patients with non-small cell lung cancer (NSCLC) with programmed death ligand 1 (PD-L1) expression, treatment with atezolizumab results in longer overall survival than chemotherapy, according to a study published in the October 1 issue of the New England Journal of Medicine.

Roy S. Herbst, MD, PhD, from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a randomized trial involving 572 patients with metastatic nonsquamous or squamous NSCLC who had not received chemotherapy and who had PD-L1 expression. Patients were randomly assigned to receive either atezolizumab or chemotherapy in a 1:1 ratio.

The researchers found that in the 205 patients with EGFR and ALK wild-type tumors who had the highest PD-L1 expression, median overall survival was longer in the atezolizumab group than the chemotherapy group (20.2 vs 13.1 months; hazard ratio for death, 0.59). Adverse events occurred in 90.2 and 94.7% of patients in the atezolizumab and chemotherapy groups, respectively, among all those who could be evaluated for safety; grade 3 and 4 adverse events occurred in 30.1 and 52.5%, respectively. In subgroups with a high blood-based tumor mutational burden, overall and progression-free survival favored the atezolizumab group.

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“We found that atezolizumab monotherapy resulted in longer overall survival than platinum-based combination chemotherapy among patients with previously untreated metastatic NSCLC with high expression of PD-L1,” the authors write.


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The study was funded by F. Hoffmann-La Roche/Genentech, the manufacturer of atezolizumab.

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