Dr. Bertino on the Impact of the EGFR-Mutated Subset Analysis of IMpower150 in NSCLC

Erin M. Bertino, MD, a medical oncologist at The Ohio State University Comprehensive Cancer Center—James, discusses the impact of the EGFR-mutated subset analysis of the phase 3 IMpower150 trial on the use of immunotherapy in patients with non—small cell lung cancer (NSCLC).

The IMpower150 trial randomized patients with stage IV nonsquamous NSCLC 1:1:1 to receive either atezolizumab (Tecentriq) plus bevacizumab (Avastin) and carboplatin/paclitaxel (ABCP); atezolizumab plus carboplatin/paclitaxel (ACP); or bevacizumab plus carboplatin/paclitaxel (BCP).

Results showed improved progression-free survival and overall survival (OS) with the quadruplet regimen in all-comers with metastatic nonsquamous NSCLC who had not previously received chemotherapy. Additionally, patients with EGFR-mutant NSCLC also derived benefit from ABCP, though OS was not statistically significant.

Data from the IMpower150 and IMpower130 trials showed limited efficacy with the combination of chemotherapy and immunotherapy in this subgroup of patients.

While ABCP is not an FDA-approved treatment for patients with EGFR-mutant NSCLC, it could be applicable in the second-line setting for patients who progress on frontline osimertinib (Tagrisso) where limited options are available, concludes Bertino.