What is the role of atezolizumab (Tecentriq) in the treatment of metastatic non–small cell lung cancer (NSCLC)?

Updated: Jul 15, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Another monoclonal antibody to PD-L1, atezolizumab was approved for patients with metastatic NSCLC who have disease progression during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving atezolizumab. Approval was based on the phase III OAK and phase II POPLAR studies. In the OAK study, survival benefit of atezolizumab was compared with docetaxel chemotherapy, regardless of PD-L1 status. Patients receiving atezolizumab lived a median 4.2 months longer than those treated with docetaxel chemotherapy. [198, 199]

In May 2020, atezolizumab was FDA-approved for first-line treatment for metastatic NSCLC in patients whose tumors have high PD-L1 expression (PD-L1 stained ≥50% of tumor cells [TC ≥50%] or PD-L1 stained tumor-infiltrating immune cells [IC] covering ≥10% of the tumor area [IC ≥10%]). Approval was based on the phase III IMpower110 trial, a multicenter, international, randomized, open-label trial. Patients were randomized to receive either atezolizumab or a platinum-based chemotherapy. Median overall survival was 20.2 months in the atezolizumab arm and 13.1 months in the chemotherapy arm, which was a 7.1-month improvement in overall survival in the atezolizumab arm. [200]


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