Slide 1: Patterns of Disease Progression After Carboplatin/Etoposide + Atezolizumab in ES-SCLC
Patterns of Disease Progression After Carboplatin/Etoposide + Atezolizumab in Extensive-Stage Small Cell Lung Cancer Kristin A. Higgins1, Walter Curran1, Stephen V. Liu2, Wei Yu3, Michelle Brockman3, Ann Johnson3, Ilze Bara3, Jeffrey D. Bradley1 1 Department of Radiation Oncology, Winship Cancer Ins
Slide 2: Disclosure
Disclosure • Dr Higgins has the following relationships to disclose: • Funded research: RefleXion Medical • Consultant/advisory board: AstraZeneca, Genentech Higgins et al. IMpower133 Progression Patterns. 2
Slide 3: Introduction
Introduction IMpower133: Updated OS in ITT2 • Atezolizumab + CP/ET has become the 1L SOC in ES-SCLC after the Phase III IMpower133 trial showed an OS improvement vs placebo + CP/ET1,2 • Atezolizumab + CP/ET was approved for 1L treatment of ES-SCLC by the FDA, EMA and other health authorities in 2019
Slide 4: IMpower133 Study Design
IMpower133 Study Design • Measurable ES-SCLC Induction Maintenance (per RECIST version 1.1) Atezolizumab + • ECOG PS 0 or 1 Survival follow-up carboplatin + etoposide Atezolizumab • No prior systemic treatment for Four 21-day cycles Treat until ES-SCLC R PD or loss • Patients with treated 1:1 of cli
Slide 5: Patients With New Brain Lesions by PCI Treatment (ITT population)
Patients With New Brain Lesions by PCI Treatment (ITT population) Atezo + CP/ET Placebo + CP/ET n (%) (n = 201) (n = 202) New brain lesions post PCI No PCI PCI No PCI baseline (n = 22) (n = 179) (n = 22) (n = 180) Yes 1 (4.5) 24 (13.4) 1 (4.5) 26 (14.4) No 21 (95.5) 155 (86.6) 21 (95.5) 154 (85.6) P
Slide 6: Time to Intra-cranial Progression (ITT Population)
Time to Intra-cranial Progression (ITT Population) Atezo + CP/ET Placebo + CP/ET (n = 201) (n = 202) Median time to 20.2 10.5 intra-cranial progression (11.0, NE) (8.7, 17.3) (95% CI), mo 0.66 (0.44, 1.00) HR (95% CI) P = 0.046a CT, computed tomography; NE, not estimable. For patients without new br
Slide 7: Time to Intra-cranial Progression in Patients Who Did Not Receive PCI
Time to Intra-cranial Progression in Patients Who Did Not Receive PCI Atezo + CP/ET Placebo + CP/ET (n = 179) (n = 180) Median time to 16.7 9.8 intra-cranial progression (10.0, 24.6) (8.6, 12.3) (95% CI), mo 0.72 (0.48, 1.09) HR (95% CI) P = 0.12a All ITT patients without PCI are included. For patie
Slide 8: PD Patterns (ITT Population)
PD Patterns (ITT Population) Sites of New Lesions in Patients Who Progressed 20 on New Lesionsa 18 16 Atezo + CP/ET Atezo + Placebo + 14 Placebo + CP/ET n (%) CP/ET CP/ET 12.4 (n = 201) (n = 202) 12 Patients (%) 10.9 10.9 PD 160 (79.6) 173 (85.6) 10.4 10.4 10 8.9 PD on 8.0 103 (51.2) 114 (56.4) 8 7.
Slide 9: Putting the Results into Context: MAVERICK (SWOG S1827)
Putting the Results into Context: MAVERICK (SWOG S1827) • Randomized Phase III trial of MRI surveillance and PCI vs MRI surveillance alone in patients with SCLC PCI • SCLC, includes LS-SCLC and ES-SCLC MRI brain R • No prior brain metastases surveillance • No brain metastases on MRI No PCI after 1L
Slide 10: Putting the Results into Context: RAPTOR (NRG-LU007)
Putting the Results into Context: RAPTOR (NRG-LU007) • Randomized Phase II/III trial of consolidation radiation + immunotherapy in patients with ES-SCLC • Data from this exploratory analysis of IMpower133 support enrollment in the RAPTOR trial • ES-SCLC Standard RT: daily, up to 5 sites Atezolizumab
Slide 11: Conclusions
Conclusions • In IMpower133, time to intra-cranial progression was delayed with atezolizumab + CP/ET vs placebo + CP/ET, suggesting potential CNS efficacy in a disease in which brain metastases are common • The most dominant pattern of progression in both treatment arms was in initial sites of disea
Slide 12: Acknowledgments
Acknowledgments • The patients enrolled in IMpower133 and their families • The investigators and clinical study sites • This study is sponsored by F. Hoffmann-La Roche, Ltd • Medical writing assistance for this oral presentation was provided by Kia C.E. Walcott, PhD, of Health Interactions and funde