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Evolving NSCLC Treatment Landscape Following IMpower010 Trial Data

IMpower010 trial data may influence a significant evolution in treatment of non–small cell lung cancer.

Millie Das, MD: This is an exciting study because we have longer-term follow-up approaching 4 years. It’s important to keep in mind that this is an interim analysis of overall survival. The disease-free survival final analysis will take place sometime in 2023. The results are event dependent. Once they hit a prespecified number of events, the results are going to be reported. It’s important to keep in mind that there are 3 other prespecified end points and the overall survival final analysis that will be shared with us once they’re available in the coming years.

I’d continue to offer adjuvant atezolizumab to patients with resected stages II and IIIA non–small cell lung cancer with a PD-L1 of greater than or equal to 1% through a shared decision-making approach. It’s an additional year of therapy. It’s important to share the available data that we have to help our patients determine whether it’s right for them. As I mentioned earlier, disease-free survival is often clinically meaningful to our patients. Although the interim overall survival isn’t statistically significant in the overall FDA-approved patient population, there’s certainly a trend seen in overall survival benefit. For patients with high PD-L1 expression, the greater than or equal to 50% subgroup of patients, I favor adjuvant atezolizumab more strongly. For those in that 1%-to-49% subgroup, the data are less clear, and it may come down to individual preferences and patient circumstances. Some patients want to do everything they can to prevent recurrence and are willing to put up with extra visits, infusions, and the potential for adverse effects. But for others, it may not be worth it.

Transcript edited for clarity.

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