Dr Nieva on the Rationale for Investigating At-Home Atezolizumab Administration in NSCLC

Jorge Nieva, MD, associate professor, clinical medicine, Keck School of Medicine, University of Southern California, discusses the rationale and design of an ongoing phase 2 trial (NCT05340309) investigating a telemedicine approach to delivering subcutaneous atezolizumab (Tecentriq) for patients with non–small cell lung cancer (NSCLC), which he presented at the 2023 IASLC World Conference on Lung Cancer.

Cancer care has undergone several changes because of the COVID-19 pandemic, Nieva says. Notably, many patients with cancer became hesitant to visit hospitals for infusion therapies during this period, Nieva emphasizes. In response to this issue, Nieva and colleagues designed a study that would enable patients to receive infusional treatments at home.

Monoclonal antibodies are known to be safe and effective when administered subcutaneously, and they are frequently administered at home. This makes them ideal candidates for home-based administration in this study, Nieva explains. The single-arm study is enrolling patients with NSCLC who are eligible to receive atezolizumab for standard indications, Nieva notes. Eligible patients include those with previously untreated, locally advanced or metastatic disease with PD-L1 expression on at least 50% of tumor cells and no EGFR or ALK aberrations; those with metastatic disease that has progressed during or after treatment with platinum-basedchemotherapy, including those with EGFR or ALK aberrations who have progressed on FDA-approved therapies; and those with stage II to IIIA disease who have undergone resection and platinum-based chemotherapy, and whose tumors express PD-L1 on at least 1% of cells. Patients’ ability to comply with this study is contingent on their ability to use smartphones.

This trial plans to enroll 37 patients. After technology training, patients will undergo liquid biopsy and in-office administration of subcutaneous atezolizumab, followed by home administration of the agent. Patients with metastatic disease will continue this treatment for up to 2 years. Patients receiving subcutaneous atezolizumab as adjuvant therapy will continue treatment with the agent for up to 1 year.