Atezolizumab versus docetaxel in pretreated patients with non-small cell lung cancer: Final results from the randomized phase 2 POPLAR and phase 3 OAK trials
In a recent publication in the Journal of Thoracic oncology, published January 1, 2021, investigators presented on long-term follow-up in patients with non-small cell lung cancer, treated in 2 randomized clinical trials. The first trial was the phase 2 POPLAR trial while the second was the phase 3 OAK trial. Both studies looked at anti – programmed cell death ligand-1 targeting immunotherapy atezolizumab in patients with previously treated advanced non-small cell lung cancer versus docetaxel. The study reported on the final overall survival and safety results from the trials combined.
Investigators looked at data from 287 patients in the POPLAR trial and 1225 patients in the OAK trial. Atezolizumab was delivered at a fixed dose of 1200 mg while docetaxel was administered at 75 mg/m². Both were given every 3 weeks.
Investigators reported a longer overall survival in patients receiving atezolizumab versus docetaxel in POPLAR , median overall survival 12.6 versus 9.7 months, with a hazard ratio of 0.76, 95% confidence interval 0.58-1.00. The 4-year overall survival rates in POPLAR were 14.8% and 8.1% while those in OAK were 15.5 and 8.7% for atezolizumab and docetaxel, respectively. An improved overall survival benefit was seen with atezolizumab versus docetaxel across all PD-L1 expression groups as well as histology groups. Patients in the docetaxel treatment arm, who survived to the 4-year mark, had received subsequent immunotherapy, 50% and 65% in POPLAR and OAK, respectively. The majority of the 4-year survivors had very good performance status and non-squamous histological classification. Grade 3 and grade 4 adverse events were seen in 27% and 60% of atezolizumab 4-year survivors in POPLAR and OAK, respectively.
The authors concluded that a consistent survival benefit was seen with a atezolizumab versus docetaxel and long-term follow-up patients with previously treated non-small cell lung cancer regardless of histology, PD-L1 expression and subsequent immunotherapy. No new safety signals were reported.