Atezolizumab is now available on the Pharmaceutical Benefits Scheme (PBS) for the first-line treatment of extensive-stage small cell lung cancer (ES-SCLC).
In the IMPOWER-133 trial, atezolizumab was used in conjunction with etoposide and platinum chemotherapy in ES-SCLC, opening up a new standard of care for these patients.
The median duration follow up was 22.9 months and atezolizumab was associated with a significant improvement in efficacy (median overall survival of 12.3 months versus 10.3 months; median duration of action of 4.2 months versus 3.9 months) compared to etoposide and platinum-based chemotherapy alone. In addition, 9.1% of patients demonstrated ongoing response with the triplet chemo-immunotherapy at clinical cut-off date compared to 2.3% of patients on chemotherapy.
The incidence of treatment-related adverse effects was similar between the treatment arms. However, immune-mediated adverse effects including hypothyroidism and hyperthyroidism, hepatitis, rash and infusion reactions were markedly higher with atezolizumab combination at 41.4% and chemotherapy at 24.5%.
- Horn L, Mansfield AS, Szczęsna A, Havel L, Krzakowski M, Hochmair MJ, et al First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer. N Engl J Med. 2018; 379: 2220-9.
- Reck M, Liu SV, Mansfield AS, Mok TS, Scherpereel A, Reinmuth N, et al. IMpower133: Updated Overall Survival (OS) Analysis of First-Line (1L) Atzeolizumab (Atezo) + Carboplatin + Etoposide in Extensive-Stage SCLC (ES-SCLC) Annals of Oncology 2019; 30(suppl_5): v710-7.
- Tecentriq® (Atezolizumab) Australian approved product information. Sydney: Roche Products. Approved February 2020.