Patients with metastatic (spreading to other parts of the body) non–small-cell lung cancer who received the drug Tecentriq (atezolizumab) as a first-line therapy had improvements in physical functioning, without worsening of their lung cancer–related symptoms, compared with patients who received chemotherapy.
These results are from the IMpower110 clinical trial, which were presented at the 2020 ASCO annual meeting by Filippo de Marinis, MD, Director of Thoracic Oncology, European Institute of Oncology, Milan, Italy.
Atezolizumab is an immunotherapy, which is a type of treatment that helps a person’s own immune system to fight against cancer cells.
“Patient-reported outcomes evaluating treatment-related symptoms, health-related quality of life, and the functional impact of treatment provide evidence of the patient experience with atezolizumab, and are important for informing us of the benefits and risks of therapy, as well as for guiding treatment decisions,” said Dr. de Marinis, the study’s lead investigator.
The IMpower110 Study
The first results from the IMpower110 clinical trial showed that atezolizumab led to longer survival in these patients compared with chemotherapy. At the ASCO meeting, Dr. de Marinis presented patients’ perspectives on the overall benefit they derived from atezolizumab.
Patients filled out 2 questionnaires for the investigators to evaluate health-related quality of life, as well as lung cancer–related symptoms and functioning using the QLQ-C30 questionnaire and the lung cancer module QLQ-LC13 questionnaire. The patients completed these assessments on electronic patient-reported outcome devices, and these outcomes were assessed by measuring their scores.
A “clinically meaningful change” in patient-reported outcomes was defined as more than a 10-point drop from the score each patient had at the beginning of the study.
The completion rates for these questionnaires were high, with more than 80% of patients in both study groups self-reporting their treatment-related symptoms throughout the duration of the study.
“The patient-reported disease burden, as assessed by symptoms and impact on functioning, was comparable between the treatment arms at baseline,” Dr. de Marinis noted. “Patients generally reported moderate physical functioning, role functioning and global health status, and a minimal symptom burden at baseline.”
The change in physical functioning from the start of the study (baseline) to week 42 of the study was modestly improved with atezolizumab, and was more than or similar to the change seen with chemotherapy. No clinically meaningful worsening in shortness of breath, cough, or chest pain was seen with atezolizumab versus with chemotherapy. In addition, a clinically meaningful improvement in cough (more than a 10-point change) was seen by week 42 and week 48 in the group that received atezolizumab.
The time to deterioration of lung cancer–related symptoms was similar in the patients who received atezolizumab and in those who received chemotherapy. According to Dr. de Marinis, this result suggests that patients’ low baseline symptom burden was maintained for a similar length of time in both treatment groups.
Finally, the investigators observed numeric improvements in chest pain, fatigue, and nausea or vomiting scores that began to rise immediately after the start of treatment and were maintained to week 48 with atezolizumab.
“Although these symptoms did not reach a clinically meaningful improvement, represented by a change greater than 10 points, a change of less than 10 points has been shown to represent an important change for patients in other trials,” he pointed out. “These trends are still important findings to note.”