Phase III IMpower150 Study Showed Tecentriq (atezolizumab) and Avastin (bevacizumab) Plus Chemotherapy Reduced the Risk of Disease Worsening or Death by 38 Percent for People with a Type of Advanced Lung Cancer
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- Published on Thursday, 07 December 2017 09:21
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-- First Phase III combination trial of a cancer immunotherapy to show improvement in progression-free survival as an initial treatment in advanced non-squamous non-small cell lung cancer (NSCLC) –
SOUTH SAN FRANCISCO, CA, USA I December 6, 2017 I Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced results from the positive, pivotal Phase III IMpower150 study of TECENTRIQ® (atezolizumab) and Avastin® (bevacizumab) plus chemotherapy (carboplatin and paclitaxel) in people with previously untreated, advanced non-squamous non-small cell lung cancer (NSCLC). The study showed that people who received TECENTRIQ and Avastin plus chemotherapy had a 38 percent reduced risk of their disease worsening or death (progression-free survival, PFS) compared with those who received Avastin plus chemotherapy (hazard ratio [HR]=0.62, p<0.0001, 95 percent CI: 0.52-0.74; median PFS = 8.3 vs. 6.8 months). Importantly, a doubling of the 12-month landmark PFS rate was observed with the combination of TECENTRIQ and Avastin plus chemotherapy (37 percent) compared to Avastin plus chemotherapy (18 percent). The rate of tumor shrinkage (overall response rate, ORR), a secondary endpoint in the study, was higher in people treated with TECENTRIQ and Avastin plus chemotherapy compared with Avastin plus chemotherapy (64 percent vs. 48 percent). The safety profile of the TECENTRIQ and Avastin plus chemotherapy combination was consistent with the safety profiles of the individual medicines, and no new safety signals were identified with the combination.
The analysis of the co-primary PFS endpoint in IMpower150 was assessed in two populations: all randomized people without an ALK or EGFR genetic mutation (intention-to-treat wild-type, ITT-WT) and in a subgroup of people who had a specific biomarker (T-effector “Teff” gene signature expression, Teff-WT). IMpower150 met its PFS co-primary endpoint per study protocol for both populations assessed. In the Teff-WT population, the combination of TECENTRIQ and Avastin plus chemotherapy reduced the risk of disease worsening or death by 49 percent compared to Avastin plus chemotherapy (HR=0.51, p<0.0001, 95% CI: 0.38-0.68; median PFS = 11.3 vs. 6.8 months).
“This TECENTRIQ study is the first positive Phase III combination trial that showed a cancer immunotherapy reduced the risk of the disease getting worse when used as an initial treatment in a broad group of people with advanced non-squamous NSCLC,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “The IMpower150 study represents an important advance in lung cancer treatment, and we will submit these results to regulatory authorities around the world to potentially bring a new standard of care to people living with this disease as soon as possible.”
The late-breaking IMpower150 data will be presented at the European Society for Medical Oncology (ESMO) Immuno Oncology Congress (Abstract #LBA1_PR) on Thursday, December 7, 6:15 p.m. Central European Time (CET) and are also part of the official press program. Early results from the co-primary endpoint of overall survival (OS) are encouraging. While they are not yet fully mature, these preliminary OS results will be presented at the ESMO IO Congress. The next analysis of survival is expected in the first half of 2018.
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. Due to pre-specified statistical testing hierarchy, Arm A vs. Arm C has not been formally tested yet. IMpower150 was designed to formally compare TECENTRIQ plus chemotherapy (Arm A) vs. 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). These OS results are expected in the first half of 2018.
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 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, as determined by the investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), and OS.
A summary of the IMpower150 Arm B vs. Arm C PFS and ORR results are included below; additional data, including preliminary OS results and Arm A vs. Arm C PFS will be presented as part of the Late-Breaking Abstract presentation.
IRF-assessed PFS showed a similar benefit for Arm B vs. Arm C as INV-assessed PFS in the Teff-WT population
Independent review facility (IRF)-assessed PFS demonstrated a similar benefit with Arm B vs. Arm C as INV-assessed PFS in the ITT-WT population
HR, hazard ratio; ORR, overall response rate; PFS, progression-free survival; WT, wild-type; Teff, T-effector; IC, tumor-infiltrating immune cells; TC, tumor cells
a WT populations exclude patients with EGFR or ALK driver mutations.
*Inclusion criteria included people with an EGFR mutation who had experienced disease progression (during or after treatment) or intolerance to treatment with one or more EGFR TKIs or people with an ALK mutation who experienced disease progression (during or after treatment) or intolerance to treatment with one or more ALK inhibitors.
The safety profile of TECENTRIQ and Avastin plus chemotherapy combination was consistent with the safety profiles of the individual medicines, and no new safety signals were identified with the combination. Serious adverse events related to treatment were observed in 25.4 percent of people who received TECENTRIQ and Avastin plus chemotherapy compared to 19.3 percent of those who received Avastin plus chemotherapy.
About lung cancer
According to the American Cancer Society, it is estimated that more than 222,000 Americans will be diagnosed with lung cancer in 2017, 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).
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 or 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.