Phase III IMpower150 Study Showed Genentech's TECENTRIQ and Avastin Plus Carboplatin and Paclitaxel Helped People With a Specific Type of Metastatic Lung Cancer Live Significantly Longer Compared to Avastin Plus Carboplatin and Paclitaxel
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- Published on Thursday, 17 May 2018 10:29
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A survival advantage for the TECENTRIQ and Avastin combination regimen was observed in all pre-specified exploratory patient subgroups analyzed, including people with EGFR and ALK mutations, liver metastases and those with varying levels of PD-L1 expression
Data will be presented at American Society of Clinical Oncology (ASCO) Annual Meeting on June 4, 2018
SOUTH SAN FRANCISCO, CA, USA I May 16, 2018 I Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced positive results from the Phase III IMpower150 study of TECENTRIQ ® (atezolizumab) and Avastin® (bevacizumab) plus carboplatin and paclitaxel (chemotherapy) for the initial (first-line) treatment of chemotherapy-naïve people with metastatic non-squamous non-small cell lung cancer (NSCLC). This interim analysis showed that TECENTRIQ and Avastin plus carboplatin and paclitaxel helped people live significantly longer compared with Avastin plus carboplatin and paclitaxel (median overall survival [OS] = 19.2 versus 14.7 months; hazard ratio [HR] = 0.78, 95 percent CI: 0.64-0.96; p=0.016) in the intention-to-treat wild-type (ITT-WT) population, a co-primary endpoint of the study. An OS advantage was observed in all pre-specified exploratory biomarker-selected subgroups analyzed, which included people with EGFR- and ALK-positive mutations who had received an appropriate targeted therapy, and those with varying levels of PD-L1 expression or with negative PD-L1 expression. People with liver metastases treated with the TECENTRIQ combination also had a survival advantage. The safety profile of the TECENTRIQ and Avastin plus carboplatin and paclitaxel combination was consistent with the safety profiles of the individual medicines, and no new safety signals were identified with the combination.
“The IMpower150 study results showed a significant survival benefit, adding to the clinical evidence supporting the combination of TECENTRIQ and Avastin as an initial treatment for metastatic non-squamous non-small cell lung cancer. An overall survival benefit was also observed in key populations such as people with EGFR- and ALK-positive mutations and those with liver metastases,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “We are working with health authorities around the world to bring this potential TECENTRIQ combination regimen to people living with this disease.”
At this interim analysis, the combination of TECENTRIQ plus carboplatin and paclitaxel (Arm A) did not show a statistically significant OS benefit when compared to the combination of Avastin plus carboplatin and paclitaxel (Arm C). Arm A will continue as planned to the final analysis. Safety in the TECENTRIQ plus carboplatin and paclitaxel arm appeared consistent with the known safety profile of the individual medicines, and no new safety signals were identified with the combination.
The official data presentation at the American Society of Clinical Oncology (ASCO) Annual Meeting will be on Monday, June 4, 2018, at 3:45 – 3:57 p.m. CDT (Abstract #9002).
The combination of TECENTRIQ and Avastin plus carboplatin and paclitaxel was recently granted Priority Review from the U.S. Food and Drug Administration (FDA) for the initial (first-line) treatment of chemotherapy-naïve people with metastatic non-squamous NSCLC. The FDA is expected to make a decision on approval by September 5, 2018.
IMpower150 is one of eight Phase III lung cancer studies underway, evaluating TECENTRIQ alone or in combination with other medicines. Following the IMpower150 and IMpower131 studies, three more Phase III lung cancer studies are expected to report this year.
About the IMpower150 study
IMpower150 is a multicenter, open-label, randomized, controlled Phase III study evaluating the efficacy and safety of TECENTRIQ in combination with chemotherapy (carboplatin and paclitaxel) with or without Avastin in people with stage IV or recurrent metastatic non-squamous NSCLC who had not been treated with chemotherapy for their advanced disease. It enrolled 1,202 people of which those with ALK and EGFR mutations were excluded from the primary ITT analysis. People were randomized (1:1:1) to receive:
- TECENTRIQ plus carboplatin and paclitaxel (Arm A), or
- TECENTRIQ and Avastin plus carboplatin and paclitaxel (Arm B), or
- Avastin plus carboplatin and paclitaxel (Arm C, control arm).
During the treatment-induction phase, people in Arm A received TECENTRIQ administered intravenously at 1200 mg in combination with intravenous infusion of carboplatin and paclitaxel on Day 1 of a 3-week treatment cycle for 4 or 6 cycles. Following the induction phase, people received maintenance treatment with TECENTRIQ (1200 mg every 3 weeks) until loss of clinical benefit or disease progression. IMpower150 was designed to formally compare TECENTRIQ plus chemotherapy (Arm A) versus Avastin plus chemotherapy (Arm C), only if TECENTRIQ and Avastin plus chemotherapy (Arm B) is shown to improve OS in the ITT-WT population compared to Avastin plus chemotherapy (Arm C).
People in Arm B received induction treatment with TECENTRIQ (1200 mg) and Avastin administered intravenously at 15 mg/kg in combination with intravenous infusion of carboplatin and paclitaxel on Day 1 of a 3-week treatment cycle for 4 or 6 cycles. People then received maintenance treatment with the TECENTRIQ and Avastin regimen until disease progression (Avastin) or loss of clinical benefit/disease progression (TECENTRIQ).
People in Arm C received induction treatment with Avastin administered intravenously at 15 mg/kg plus intravenous infusion of carboplatin and paclitaxel on Day 1 of a 3-week treatment cycle for 4 or 6 cycles. This was followed by maintenance treatment with Avastin alone until disease progression.
The co-primary endpoints were PFS and OS, as determined by the investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1). The co-primary OS endpoint in IMpower150 was assessed in all randomized people without an EGFR or ALK genetic mutation (intention-to-treat wild-type). Key secondary endpoints included investigator-assessed PFS, OS and safety in the ITT population and in EGFR and ALK mutation subgroups. The study met its co-primary endpoints of OS and PFS per study protocol.
A summary of OS results are included below.
|Arm B (TECENTRIQ and Avastin plus chemotherapy) vs Arm C (Avastin plus chemotherapy) OS in Populations of Interest|
|Population||No. of Pts||HR (95 percent CI)||mOS, mo|
|Arm B||Arm C|
|ITT-WTa||696||0.78 (0.64, 0.96)||19.2||14.7|
|ITT||800||0.76 (0.63, 0.93)||19.8||14.9|
|EGFR/ALK+||104||0.54 (0.29, 1.03)||NR||17.5|
|Liver metastasesb||94||0.54 (0.33, 0.88)||13.2||9.1|
|Subgroups in ITT-WT|
|TC1/2/3 or IC1/2/3||357||0.77 (0.58, 1.04)||22.5||16.4|
|TC0 and IC0||339||0.82 (0.62, 1.08)||17.1||14.1|
|Teff-high||285||0.83 (0.59, 1.17)||25.0||16.7|
|Teff-low||377||0.78 (0.60, 1.02)||17.6||14.3|
|IC, tumor-infiltrating immune cells; NR, not reached; TC, tumor cells.
a WT excludes patients with EGFR or ALK genomic alterations.
b Present at baseline. TC1/2/3 or ICI1/2/3 = PD-L1+ ≥ 1 percent of TC or IC; TC0 and IC0 = PD-L1+ < 1 percent of TC and IC.
The safety profile of the TECENTRIQ and Avastin plus carboplatin and paclitaxel combination was consistent with the safety profiles of the individual medicines, and no new safety signals were identified with the combination. Serious adverse events (Grade 3-4) related to treatment were observed in 57 percent of people who received TECENTRIQ and Avastin plus carboplatin and paclitaxel compared to 49 percent of those who received Avastin plus carboplatin and paclitaxel.
About lung cancer
According to the American Cancer Society, it is estimated that more than 234,000 Americans will be diagnosed with lung cancer in 2018, and NSCLC accounts for 85 percent of all lung cancers. It is estimated that approximately 60 percent of lung cancer diagnoses in the United States are made when the disease is in the advanced stages.
About the TECENTRIQ® (atezolizumab) and Avastin® (bevacizumab) combination
There is a strong scientific rationale to support further investigation of TECENTRIQ plus Avastin in combination. We are investigating this combination in a broad range of cancers, including first-line advanced NSCLC. Avastin, in addition to its anti-angiogenic effects, may further enhance TECENTRIQ’s ability to restore anti-cancer immunity by inhibiting VEGF-related immunosuppression, promoting T-cell tumor infiltration and enabling priming and activation of T-cell responses against tumor antigens.
About TECENTRIQ® (atezolizumab)
TECENTRIQ is a monoclonal antibody designed to bind with a protein called PD-L1. TECENTRIQ is designed to bind to PD-L1 expressed on tumor cells and tumor-infiltrating immune cells, blocking its interactions with both PD-1 and B7.1 receptors. By inhibiting PD-L1, TECENTRIQ may enable the re-activation of T cells. TECENTRIQ may also affect normal cells.
About Avastin® (bevacizumab)
Avastin is a prescription-only medicine that is a solution for intravenous infusion. It is a biologic antibody designed to specifically bind to a protein called vascular endothelial growth factor (VEGF) that plays an important role throughout the lifecycle of the tumor to develop and maintain blood vessels, a process known as angiogenesis. Avastin is designed to interfere with the tumor blood supply by directly binding to the VEGF protein to prevent interactions with receptors on blood vessel cells. The tumor blood supply is thought to be critical to a tumor's ability to grow and spread in the body (metastasize).
TECENTRIQ U.S. Indication (pronounced ‘tē-SEN-trik’)
TECENTRIQ is a prescription medicine used to treat:
a type of bladder and urinary tract cancer called urothelial carcinoma.
- TECENTRIQ may be used when your bladder cancer:
- has spread or cannot be removed by surgery (advanced urothelial carcinoma), and
- you are not able to take chemotherapy that contains a medicine called cisplatin, or
- you have tried chemotherapy that contains platinum, and it did not work or is no longer working
The approval of TECENTRIQ in these patients is based on a study that measured response rate and duration of response. There is an ongoing study to confirm clinical benefit.
A type of lung cancer called non-small cell lung cancer (NSCLC).
- TECENTRIQ may be used when your lung cancer:
- has spread or grown, and
- you have tried chemotherapy that contains platinum, and it did not work or is no longer working
If your tumor has an abnormal EGFR or ALK gene, you should have also tried an FDA-approved therapy for tumors with these abnormal genes, and it did not work or is no longer working.
About Genentech in Personalized Cancer Immunotherapy
For more than 30 years, Genentech has been developing medicines with the goal to redefine treatment in oncology. Today, we’re investing more than ever to bring personalized cancer immunotherapy (PCI) to people with cancer. The goal of PCI is to provide each person with a treatment tailored to harness his or her own immune system to fight cancer. Genentech is studying more than 20 investigational medicines, 10 of which are in clinical trials. In every study we are evaluating biomarkers to identify which people may be appropriate candidates for our medicines. For more information visit http://www.gene.com/cancer-immunotherapy.
About Genentech in Lung Cancer
Lung cancer is a major area of focus and investment for Genentech, and we are committed to developing new approaches, medicines and tests that can help people with this deadly disease. Our goal is to provide an effective treatment option for every person diagnosed with lung cancer. We currently have four approved medicines to treat certain kinds of lung cancer and more than 10 medicines being developed to target the most common genetic drivers of lung cancer or to boost the immune system to combat the disease.
Founded more than 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and commercializes medicines to treat patients with serious and life-threatening medical conditions. The company, a member of the Roche Group, has headquarters in South San Francisco, California. For additional information about the company, please visit http://www.gene.com.