Format

Send to

Choose Destination
N Engl J Med. 2018 Dec 6;379(23):2220-2229. doi: 10.1056/NEJMoa1809064. Epub 2018 Sep 25.

First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer.

Collaborators (695)

De Boer R, Barnet M, Boyer M, Herath D, Hughes B, Inglis PL, Kao S, Lwin Z, Morris K, Solomon B, Tan L, Thai A, Zhang A, Brehm E, Burghuber O, Dworan N, Gasser S, Hartl S, Hergan K, Hochmair M, Huemer F, Kapfhammer I, Koger R, Koköfer A, Kratochwill H, Kropfmüller R, Lamprecht B, Mikes R, Mohn-Staudner A, Pirker C, Porsch P, Rohrer B, Schmatzer I, Schober E, Stiefsohn E, Studnicka M, Andrade L, Araujo LH, Azevedo S, Borghetti AC, Brust L, Campos C, Castro Junior G, Coelho J, Costa M, Dettino A, Faccio A, Felizola M, Franke FA, Fujiki F, Gil C, Liedke PE, Lopes V, Mak M, Martins R, Mesquita C, Moura L, Pereira R, Peria F, Roitberg F, Santini F, Santos Borges G, Schlittler LA, Schuh N, Seewald R, Sousa L, Takagaki T, Tenorio Silva M, Werutsky G, Aren O, Conejeros R, Orlandi F, Quijada I, Saavedra MP, Yanez E, Yañez P, Chen Y, Cheng Y, Cui H, Ding H, Li N, Li Z, Liu J, Liu Y, Xia H, Xin Y, Xu N, Yang Y, Zhu J, Bartouskova M, Benysek V, Cernovska M, Havel L, Hudcova M, Kovar R, Melichar B, Opalka P, Pauk N, Studentova H, Vitaskova D, Debieuvre D, Baciuchka Palmaro M, Barlesi F, Brachet PE, Cabart M, Chomy F, Coquan E, Cortot A, Cousin S, Dhalluin X, Do P, Dubos Arvis C, Fournier de Lesquen C, Garcia ME, Gauvain C, Gervais R, Greillier L, Ladam B, Mascaux C, Meriaux E, Munck C, Scherpereel A, Segura C, Tomasini P, Toulmonde M, Willemin MC, Ambold M, Behlendorf T, Bischoff H, Bozorgmehr F, Duell T, Grosch H, Heigener D, Hermes A, Hofmann Y, Karin J, Knopf M, Küster C, Möller M, Reck M, Reinmuth N, Reitmeier S, Rittmeyer A, Schütte W, Storbeck B, Wagner-Hug D, Zwerger B, Argiriadi R, Boura P, Charpidou A, Frantzi T, Gerolympou M, Gkaravela T, Gkoura S, Kalofonos H, Res E, Samantas E, Sgouros J, Stamoulis G, Syrigos K, Tsimpoukis S, Vathiotis L, Visvikis A, Cheng CK, Lam KC, Lam YTM, Lee WY, Mok TSK, Poon A, Shum T, Borbely T, Kozma Z, Mark Z, Aleid S, Hidvegi E, Kelemen Z, Ostoros G, Pap M, Kardos T, Szilasi M, Kunos L, Losonczy G, Tamasi L, Buti S, Carteni G, Catania C, Chella A, De Marinis F, Del Signore E, Di Micco C, Facchinetti F, Fioroni I, Garassino M, Gelsomino F, Imbimbo M, Lo Russo G, Lucchesi M, Maiello E, Passaro A, Petrini I, Pochesci C, Proto C, Puppo G, Rossi G, Signorelli D, Spitaleri G, Tiseo M, Tonini G, Vitali M, Zilembo N, Amino Y, Abe Y, Adachi Y, Aga M, Aiba T, Akamatsu H, Akamatsu K, Aso M, Atagi S, Azuma K, Domeki Y, Enomoto T, Furuta K, Furuuchi K, Hanaoka K, Haratani K, Harita S, Hasegawa T, Hayashi H, Hayata A, Hirano K, Hiraoka R, Hirata N, Hirokawa E, Honda Y, Horiike A, Hosomi Y, Imabayashi T, Inagaki Y, Ishida T, Ito A, Iwama E, Iwasa T, Kagami R, Kagawa T, Kanai K, Kaneko Y, Katayama K, Kato R, Kato T, Kato Y, Katsuda R, Kawakami H, Kawamura T, Kawana S, Kawashima Y, Kenmotsu H, Kimura Y, Kitazono S, Kobayashi H, Kobayashi T, Koh Y, Kohno S, Kominami R, Kondo T, Kotake M, Kozuka T, Kurahara Y, Kurimoto F, Mamesaya N, Matsuda Y, Minomo S, Miyake K, Miyawaki E, Mizumori Y, Mizuno S, Mizutani H, Morise M, Murakami H, Murakami E, Murakami Y, Naito T, Nakagawa K, Nakahara Y, Nakamura A, Nakanishi M, Nakanishi Y, Nakano T, Nakao K, Nakashima K, Naoki Y, Nishihara T, Nishio M, Nishioka N, Nonagase Y, Okamoto I, Okamura T, Okishio K, Okuda Y, Okuma Y, Okuno T, Okura N, Omori S, Onda N, Onishi Y, Ono A, Ono H, Otsubo K, Otsuka K, Saijo S, Saito S, Saito R, Sakai H, Sasaki S, Shimizu H, Shimokawaji T, Sonobe S, Sugawara S, Sugimoto T, Sugisaka J, Suzuki S, Suzuki K, Suzuki M, Takahama T, Takahashi T, Takayama K, Takeda M, Takegawa N, Takei R, Takeuchi N, Takimoto T, Tamiya A, Tamiya N, Tanaka T, Tanaka K, Taniguchi Y, Tanimura K, Teraoka S, Terayama K, Toi Y, Tokura S, Tsukamoto H, Tsurumi K, Tsurutani J, Uchibori K, Uchino J, Ueda H, Uematsu S, Usui R, Wakuda K, Watanabe S, Watanabe K, Yamada K, Yamada T, Yamanda S, Yamane Y, Yamazaki A, Yanagitani N, Yokose T, Yokoyama T, Yomota M, Yonesaka K, Yoneshima Y, Yoshida T, Yoshizawa T, Ahn JS, Ahn MJ, Choi M, Heo D, Keam B, Kim DW, Kim M, Kim SW, Kim SH, Kim YJ, Lee DW, Lee DH, Lee JS, Park K, Park HK, Sun JM, Yoon SK, Alatorre Alexander JA, Añorve D, Deneken C, Enriquez Aceves MI, Garcia LV, Güemes A, Macedo E, Martinez F, Ruiz Garcia A, Fløtten Ø, Grønberg B, Helland A, Andrzejewska S, Badurak P, Bryl M, Dziadziuszko R, Dzikowska-Dalek J, Gajda-Wrzosek J, Golda-Gocka I, Gorska-Szymot M, Grabowska O, Guzowska A, Huczynska-Szubert E, Janowicz-Zebrowska A, Jaskiewicz P, Jassem J, Kalinka-Warzocha E, Kazarnowicz A, Knetki-Wróblewska M, Kolb-Sielecki J, Konopa K, Kowalczyk A, Kowalski D, Krzakowski M, Kukulska M, Mazur-Roszak M, Niedziolka A, Nikisch B, Nowak E, Nowak-Glanc M, Oniszh K, Pieniuk-Faszynska K, Piorek A, Pluzanski A, Sawicki T, Smorczewska M, Sosinska-Mielcarek K, Stankiewicz K, Sucharski W, Symonowicz I, Szambora P, Szczesna A, Torous M, Winiarczyk K, Wrona A, Zajda K, Zukowska M, Bagrova S, Danilova A, Filippov A, Gladkova A, Gorbunova V, Karaseva N, Klischuk A, Kuliev R, Kuzminov A, Levchenko E, Levchenko N, Mamontov O, Mironova G, Nikolaeva S, Nyashin V, Osheychik A, Profatilo I, Shamanskaya Y, Smolin A, Stroyakovskii D, Yurchenkov A, Yurin R, Zolotarev A, Andric Z, Bokan D, Bursac D, Cekic M, Djedovic J, Djordjevic I, Djordjevic S, Grujic M, Ilic B, Jovanovic D, Kostic S, Kovacevic T, Mihailović Vučinić V, Milutinovic N, Murtezani Z, Perin B, Popevic S, Rancic M, Samardzic N, Sarcev T, Stojanovic G, Stojsic V, Uskokovic Stefanovic Z, Zaric B, Alonso M, Alonso Gordoa T, Berciano MA, Bernabe Caro R, Cazorla López M, Cedres Perez SM, Cobo Dols M, Cruz P, De Castro Carpeno J, Fernández Ruiz A, Flor Oncala MJ, Gajate Borau P, Galán MN, Gallego I, Garrido Lopez P, Gómez Rueda A, Gomez Salcedo P, Gutierrez V, Isla Casado D, Jimenez B, Martinez A, Martinez Marin V, Navarro A, Olmedo ME, Quero Blanco C, Ramos Garcia I, Remon Masip J, Saez MI, Sanchez A, Soria Rivas A, Trigo Perez JM, Chang WC, Chao HS, Chen KY, Chiang CL, Chiu CH, Fang YF, Ho CC, Hsu CL, Lai SL, Lee JH, Li SH, Liao WY, Lin CC, Lin YL, Lin ZZ, Liu CY, Luo YH, Shiao TH, Shie RF, Shih JY, Tsai TH, Tsai CM, Wang CL, Yang CY, Yang CJ, Yang CT, Yu CJ, Erman M, Aung SD, Brand G, Califano R, Conibear J, Ford V, Gomes F, Karapanagiotou E, Lal R, Lim L, Montes A, Mooney M, Nicolson M, Powell C, Spicer J, Stillwell C, Szabados B, Toy E, Valentine Crowe E, Vigneswaran V, Adjei A, Ahn E, Alemany C, Baither J, Bajaj M, Batus M, Benton D, Bickar A, Blau S, Blom A, Bonomi P, Bowen D, Braiteh F, Bregenzer M, Brown A, Bruce J, Bumgarner K, Callaway B, Campbell T, Casper E, Chaves JM, Cogan M, Cole-Almgren M, Crane E, Creagan ET, Damon A, Daniel D, Davalli K, de Oliveira M, DeShazo D, Dugan M, Ebrahim K, Evans D, Fairfield J, Fernbach B, Fidler M, Fishkin P, Gershenhorn B, Gerstner GJ, Giuseppe G, Goldschmidt J Jr, Hamm J, Hanisch E, Harris R, Haycraft D, Hocum C, Horn L, Hussein M, Ilyas C, Induru R, Jacks K, Johns M, Johnson M, Joseph S, Kashef G, Keating TJ, Kennedy G, Khan S, Kingsley E, Kirshner E, Kloss J, Knoll D, Korst R, Kurian S, LaBrecque L, Larder H, Leal T, Lee J, Le-Lindqwister N, Leventakos K, Liu S, MacVicar G, Magnoli A, Mansfield A, Marks RS, Martin L, McCroskey R, McCune SL, McGill K, Mekhail T, Merrill K, Miles S, Miller K, Molina JR, Mowry S, Mullery A, Neelam R, Neider R, Obara G, Parikh R, Percent IJ, Pisick E, Prasad HK, Qin X, Rakowski T, Rao S, Readling J, Rehman N, Saifuddin K, Sambidi S, Samlowski W, Samu-Arce S, Sanatinia H, Sanchez JD, Schaffer D, Senecal F, Sirois TW, Socinski M, Southwick S, Spalik K, Spira AI, Subramaniam D, Suh J, Suppiah R, Teplinsky E, Thomas C, Thompson J, Traynor A, Trupti S, Varadarajan P, Veatch A, Vicuna B, Villaruz L, Vincent B, Vogelzang N, Waterman P, Weisberg TF, West N, Wood K, Wrona M, Yalamanchili M.

Abstract

BACKGROUND:

Enhancing tumor-specific T-cell immunity by inhibiting programmed death ligand 1 (PD-L1)-programmed death 1 (PD-1) signaling has shown promise in the treatment of extensive-stage small-cell lung cancer. Combining checkpoint inhibition with cytotoxic chemotherapy may have a synergistic effect and improve efficacy.

METHODS:

We conducted this double-blind, placebo-controlled, phase 3 trial to evaluate atezolizumab plus carboplatin and etoposide in patients with extensive-stage small-cell lung cancer who had not previously received treatment. Patients were randomly assigned in a 1:1 ratio to receive carboplatin and etoposide with either atezolizumab or placebo for four 21-day cycles (induction phase), followed by a maintenance phase during which they received either atezolizumab or placebo (according to the previous random assignment) until they had unacceptable toxic effects, disease progression according to Response Evaluation Criteria in Solid Tumors, version 1.1, or no additional clinical benefit. The two primary end points were investigator-assessed progression-free survival and overall survival in the intention-to-treat population.

RESULTS:

A total of 201 patients were randomly assigned to the atezolizumab group, and 202 patients to the placebo group. At a median follow-up of 13.9 months, the median overall survival was 12.3 months in the atezolizumab group and 10.3 months in the placebo group (hazard ratio for death, 0.70; 95% confidence interval [CI], 0.54 to 0.91; P=0.007). The median progression-free survival was 5.2 months and 4.3 months, respectively (hazard ratio for disease progression or death, 0.77; 95% CI, 0.62 to 0.96; P=0.02). The safety profile of atezolizumab plus carboplatin and etoposide was consistent with the previously reported safety profile of the individual agents, with no new findings observed.

CONCLUSIONS:

The addition of atezolizumab to chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer resulted in significantly longer overall survival and progression-free survival than chemotherapy alone. (Funded by F. Hoffmann-La Roche/Genentech; IMpower133 ClinicalTrials.gov number, NCT02763579 .).

PMID:
30280641
DOI:
10.1056/NEJMoa1809064
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center