Tecentriq–Chemotherapy Combination Demonstrates Increased Survival in ES-SCLC

This week, drug maker Roche released positive data from its phase 3 IMpower133 study that investigated an immunotherapy-based combination of atezolizumab (Tecentriq) and chemotherapy in the treatment of extensive-stage small cell lung cancer (ES-SCLC).

The IMpower133 trial is a phase 3, multicenter, double-blinded, randomized study that looked to evaluate the efficacy and safety of atezolizumab in combination with carboplatin and etoposide versus carboplatin plus etoposide (chemotherapy) alone in chemotherapy-naïve patients with ES-SCLC.

The study randomized 403 participants 1:1 to receive atezolizumab in combination with chemotherapy (arm A) or placebo in combination with chemotherapy (arm B). The trial achieved its co-primary endpoints of progression-free survival and overall survival.

“These are the first positive phase 3 survival results for any immunotherapy-based combination in the initial treatment of extensive-stage small cell lung cancer, a particularly difficult to treat type of disease,” said Sandra Horning, MD, chief medical officer and head of global product development at Roche in a statement.

The immunotherapy-based combination treatment also reduced the risk of disease worsening or death compared with chemotherapy alone. In addition, safety for the combination treatment appeared consistent with the known safety profile of each medicine, respectively, and no new safety concerns were identified with treatment.

However, last week the FDA released a statement restricting the use of pembrolizumab (Keytruda) and atezolizumab for patients with locally advanced or metastatic urothelial cancer who are not eligible for cisplatin-containing therapy. This decision was based on data that demonstrated decreased survival associated with each drug as a monotherapy compared with platinum-based chemotherapy in clinical trials.

The results of the IMpower133 trial are the 5th positive study data evaluating an atezolizumab-based combination. Roche continues to study the drug with 8 ongoing lung cancer trials that are investigating atezolizumab’s efficacy alone or in combination with other treatments across various lung cancers.

“The clinically meaningful results from the IMpower133 study add to the growing body of evidence demonstrating that Tecentriq-based combinations may be an effective treatment for different types of advanced lung cancer. We look forward to working with health authorities globally to bring this potential treatment option to people with this type of disease as soon as possible,” said Horning.

Roche plans to present the full data from the trial at an upcoming medical meeting.