- Neoadjuvant atezolizumab resulted in a promising major pathological response (MPR) rate and was well-tolerated in patients with resectable NSCLC.
Why this matters
- Results warrant further study of neoadjuvant atezolizumab in resectable NSCLC.
- Biomarker analyses conducted could increase understanding of lung cancer immunology in neoadjuvant atezolizumab setting.
- Preliminary analysis of first 54/180 planned patients with resectable, untreated NSCLC enrolled in phase 2, open-label, multicenter, single-arm LCMC3 trial.
- Treatment with 2 cycles atezolizumab, 1200 mg on days 1, 22 presurgery.
- Tumor biopsies, peripheral blood taken for biomarker analyses.
- Primary endpoint: MPR rate (10% viable tumor cells).
- Funding: Genentech, Inc.
- 45 patients in efficacy-evaluable population.
- 10 (22%) achieved MPR (95% CI: 11%-37%).
- Treatment-related adverse events (TRAEs) with >5% incidence were grade 1-2; 2 patients had grade 3 TRAEs.
- 31 patients in biomarker evaluable population. After neoadjuvant atezolizumab:
- Significant increases in natural killer cells, CD8+ T-cells, Th1-response-related dendritic cells; decrease in B-cells.
- Immune subset changes related to MPR, programmed death-ligand 1 (PD-L1) status also observed.
- Increase in PD-L1+ immune cells in most patients.
- Trial ongoing (135 patients enrolled as of 2/28/2019).
- More research needed on role of immune cell changes in clinical, pathological outcomes.