IMpower151 in Metastatic NSqNSCLC: Atezolizumab Combo Falls Short on Primary Endpoint

In this randomized double-blind phase 3 trial conducted in China with 305 chemotherapy-naive metastatic non-squamous NSCLC patients—53% of whom had EGFR+ tumors—the combination of atezolizumab, bevacizumab, carboplatin, and primarily pemetrexed (ABCPem/Pac) yielded a median investigator-assessed PFS of 9.5 months versus 7.1 months with the control regimen, but with a non-significant hazard ratio (0.84, 95% CI: 0.65–1.09, P = 0.184); overall survival and response rates were comparable between arms, and the safety profile was manageable with expected immune-related adverse events.

These results indicate that while the ABCPem/Pac regimen was well tolerated, the addition of atezolizumab did not significantly enhance progression-free survival in this metastatic nsqNSCLC population, prompting further exploration of biomarker-driven strategies and combination approaches.