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First-line atezolizumab monotherapy vs. single-agent chemotherapy in patients with advanced or metastatic non-small cell lung cancer who are ineligible for platinum-based therapy: Analysis of the IPSOS Asian subpopulation

Year: 2025

Type: article

Abstract: BACKGROUND: Lung cancer remains a significant medical problem in Asia, and improved treatments are needed for patients diagnosed with non-small cell lung cancer (NSCLC), who are frail with poor performance status or substantial comorbidities. This study aimed to investigate the efficacy and safety of first-line atezolizumab vs . single-agent chemotherapy in the Asian subpopulation in IPSOS trial. METHODS: This exploratory analysis of the Asian subpopulation from the phase 3, global, open-label, randomized controlled IPSOS trial evaluated the efficacy and safety of atezolizumab (1200 mg intravenously every 3 weeks) vs . single-agent chemotherapy (investigator's choice of vinorelbine or gemcitabine) as first-line treatment in patients with locally advanced or metastatic NSCLC, who were ineligible for platinum-based chemotherapy. The primary outcome was overall survival (OS); other outcomes were progression-free survival (PFS), objective response rate (ORR), duration of response (DOR), and safety. RESULTS: Seventy patients from China and Vietnam were included. Median OS was 15.8 months in the atezolizumab group vs . 12.5 months in the chemotherapy group; unstratified hazard ratio, 0.74 (95% confidence interval 0.41, 1.35). Median PFS was 8.1 months vs . 5.4 months, ORR was 27.9% vs . 7.4%, and median DOR was 18.7 months vs . 9.3 months, in the atezolizumab group vs . in the chemotherapy group, respectively. All-grade and grade 3-4 treatment-related adverse events (AEs) were less frequent with atezolizumab compared with chemotherapy. Two patients in the atezolizumab group had grade 5 AEs, namely pneumonia and acute left ventricular failure, with the latter considered treatment-related. CONCLUSIONS: Atezolizumab showed encouraging efficacy results and was well tolerated in an Asian subpopulation of patients with NSCLC who were deemed ineligible for standard platinum-based chemotherapy. The findings of this exploratory subpopulation analysis were consistent with those for the global IPSOS population. REGISTRATION: ClinicalTrials.gov , NCT03191786.

Source: Chinese Medical Journal

DOI: 10.1097/cm9.0000000000003796