Atezolizumab Plus Chemotherapy for First-Line Treatment of Non-Squamous Non-Small Cell Lung Cancer: Results From the Randomized Phase III IMpower132 Trial

ABSTRACT INTRODUCTION We report final results from the Phase III IMpower132 study evaluating atezolizumab plus carboplatin or cisplatin and pemetrexed (APP) in patients with non-squamous non-small cell lung cancer (NSCLC). METHODS Chemotherapy-naive patients with stage IV non-squamous NSCLC without sensitizing EGFR or ALK genetic alterations were randomized 1:1 to receive 4 or 6 cycles of carboplatin or cisplatin plus pemetrexed (PP) or APP every 3 weeks, followed by maintenance therapy with atezolizumab plus pemetrexed or pemetrexed alone. Co-primary endpoints were overall survival (OS) and investigator-assessed progression-free survival (PFS). RESULTS The intention-to-treat population included 578 patients (APP, n=292; PP, n=286). At the primary PFS analysis (May 22, 2018; median follow-up, 14.8 months), APP demonstrated significant PFS improvement vs PP (median, 7.6 vs 5.2 months; stratified HR, 0.60 [95% CI: 0.49, 0.72]; P CONCLUSIONS IMpower132 met its co-primary PFS endpoint but not its co-primary OS endpoint, with numerical improvement for OS in the APP arm. APP had a manageable safety profile, with no new or unexpected safety signals identified.