Atezolizumab in patients with advanced non-small-cell lung cancer who are platinum-doublet ineligible
Mené sur 453 patients atteints d'un cancer du poumon non à petites cellules de stade IIIB ou IV et inéligibles à un doublet de chimiothérapie à base de platine, cet essai randomisé international de phase III compare l'efficacité, du point de vue de la survie globale, et la sécurité de deux types de monothérapie de première ligne, l'une par atézolizumab et l'autre par chimiothérapie
Immune checkpoint inhibitors have revolutionised nonsmall-cell lung cancer (NSCLC) management. Before these inhibitors, 5-year survival rates were 0% for stage IVB disease but now approach 20% in those without substantial comorbidities and Eastern Cooperative Oncology Group performance status (ECOG PS) scores of 0 or 1, regardless of PD-L1 expression. However, this study population and hence outcome does not represent the majority of real-world patients: older people (ie, those 70 years and older), those with substantial comorbidities, frailty, and a poor ECOG PS score, populations that have been routinely excluded from cancer therapeutic trials, for whom rapid registration of novel indications is key, together with risk minimisation.
The Lancet , commentaire, 2022