IMpower210: A phase III study of second-line atezolizumab vs. docetaxel in East Asian patients with non-small cell lung cancer

Yi-Long Wu; Shun Lu; Gongyan Chen; Jianxing He; Jifeng Feng; Yiping Zhang; Liyan Jiang; Hongming Pan; Jianhua Chang; Jian Fang; Amy Cai; Lilian Bu; Jane Shi; Jinjing Xia

doi:10.21147/j.issn.1000-9604.2024.02.01

IMpower210: A phase III study of second-line atezolizumab vs. docetaxel in East Asian patients with non-small cell lung cancer

Chin J Cancer Res. 2024 Apr 30;36(2):103-113. doi: 10.21147/j.issn.1000-9604.2024.02.01.

Authors

Yi-Long Wu¹, Shun Lu², Gongyan Chen³, Jianxing He⁴, Jifeng Feng⁵, Yiping Zhang⁶, Liyan Jiang⁷, Hongming Pan⁸, Jianhua Chang⁹, Jian Fang¹⁰, Amy Cai¹¹, Lilian Bu¹¹, Jane Shi¹¹, Jinjing Xia¹¹

Affiliations

¹ Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China.
² Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
³ Department of Respiration, Harbin Cancer Hospital, Harbin Medical University, Harbin 150081, China.
⁴ Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
⁵ Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China.
⁶ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou 330022, China.
⁷ Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
⁸ Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
⁹ Department of Medical Oncology, Shenzhen Hospital, Cancer Hospital of Chinese Academy of Medical Sciences, Shenzhen 518116, China.
¹⁰ Department of Thoracic Oncology, Beijing Cancer Hospital, Beijing 100142, China.
¹¹ Product Development, Shanghai Roche Pharmaceutical Ltd, Shanghai 201203, China.

PMID: 38751442
PMCID: PMC11090799
DOI: 10.21147/j.issn.1000-9604.2024.02.01

Abstract

Objective: IMpower210 (NCT02813785) explored the efficacy and safety of single-agent atezolizumab vs. docetaxel as second-line treatment for advanced non-small cell lung cancer (NSCLC) in East Asian patients.

Methods: Key eligibility criteria for this phase III, open-label, randomized study included age ≥18 years; histologically documented advanced NSCLC per the Union for International Cancer Control/American Joint Committee on Cancer staging system (7th edition); Eastern Cooperative Oncology Group performance status of 0 or 1; and disease progression following platinum-based chemotherapy for advanced or metastatic NSCLC. Patients were randomized 2:1 to receive either atezolizumab (1,200 mg) or docetaxel (75 mg/m²). The primary study endpoint was overall survival (OS) in the intention-to-treat (ITT) population with wild-type epidermal growth factor receptor expression (ITT EGFR-WT) and in the overall ITT population.

Results: Median OS in the ITT EGFR-WT population (n=467) was 12.3 [95% confidence interval (95% CI), 10.3-13.8] months in the atezolizumab arm (n=312) and 9.9 (95% CI, 7.8-13.9) months in the docetaxel arm [n=155; stratified hazard ratio (HR), 0.82; 95% CI, 0.66-1.03]. Median OS in the overall ITT population was 12.5 (95% CI, 10.8-13.8) months with atezolizumab treatment and 11.1 (95% CI, 8.4-14.2) months (n=377) with docetaxel treatment (n=188; stratified HR, 0.87; 95% CI, 0.71-1.08). Grade 3/4 treatment-related adverse events (TRAEs) occurred in 18.4% of patients in the atezolizumab arm and 50.0% of patients in the docetaxel arm.

Conclusions: IMpower210 did not meet its primary efficacy endpoint of OS in the ITT EGFR-WT or overall ITT populations. Atezolizumab was comparatively more tolerable than docetaxel, with a lower incidence of grade 3/4 TRAEs.

Keywords: Atezolizumab; East Asia; monoclonal antibody; non-small cell lung cancer; programmed death-ligand 1 inhibitors.