Searching for a chemoimmunotherapy signal in patients with non-small-cell lung cancer and EGFR mutations
Mené dans 26 pays sur 1 202 patients atteints d'un cancer du poumon non à petites cellules, cet essai de phase III compare l'efficacité, du point de vue de la survie gloable et de la survie sans progression, et la toxicité de 3 stratégies thérapeutiques combinant une chimiothérapie à base de carboplatine/paclitaxel et l'atézolizumab ou le bévacizumab (un traitement de type ABCP, de type ACP et de type BCP), en fonction de la présence de mutations EGFR et de la présence de métastases hépatiques
The programmed death-1 (PD1) inhibitor, pembrolizumab, with or without a platinum doublet, is a first-line option for most patients with stage IV non-small-cell lung cancer (NSCLC). However, NSCLC is not one disease anymore. On the basis of previous studies showing low activity of PD1 and programmed-death ligand 1 (PD-L1) inhibitor monotherapy, patients with epidermal growth factor receptor ( EGFR) mutations or anaplastic lymphoma kinase ( ALK)-rearranged disease were not included in the first-line pembrolizumab trials. By contrast, the IMpower150 and IMpower130 trials, which assessed atezolizumab (a PD-L1 inhibitor) with platinum chemotherapy, permitted these patients to enrol. Data from the subgroup of IMpower150 with EGFR mutations, presented in The Lancet Respiratory Medicine by Martin Reck and colleagues, might offer the first positive signal from chemoimmunotherapy in these patients.