Dr. Langer on the IMpower150 Trial in NSCLC

Corey J. Langer, MD, director, Thoracic Oncology, Abramson Cancer Center, professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the impact of the IMpower150 trial in patients with non—small cell lung cancer (NSCLC).

The trial tested angiogenesis inhibition in patients with advanced wild-type non-squamous NSCLC, including those with EGFR and ALK driver mutations. The trial compared the ECOG 4599 regimen of paclitaxel, carboplatin and bevacizumab (Avastin) to the same combination plus atezolizumab (Tecentriq). The addition of atezolizumab showed a significant improvement in progression-free survival, a 4.5-month improvement in median overall survival, and a hazard ratio below 0.8.

In patients with liver metastasis and those with oncogenic drivers, the hazard ratio for survival was 0.54. Langer states that this is a potential go-to regimen for patients who become refractory to tyrosine kinase inhibitors, but advises against its use in the upfront setting. Langer predicts that phase II/III trials may use pemetrexed (Alimta) for the taxane-based therapy, and ramucirumab (Cyramza) in lieu of bevacizumab.