2022 World Conference on Lung Cancer (ePosters)-EP08.02-081. Cabozantinib Plus Atezolizumab in First or Second-Line Advanced NSCLC and Previously-Treated EGFR Mutant Advanced NSCLC

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A study presented at the IASLC 2022 World Conference on Lung Cancer assessed the efficacy and safety of cabozantinib plus atezolizumab in the treatment of advanced non-small cell lung cancer (NSCLC). The study included two cohorts: one with first- or second-line advanced NSCLC patients who were PD-L1 positive and immunotherapy naive, and another with previously treated EGFR-mutant advanced NSCLC patients. <br /><br />The combination therapy showed moderate clinical activity in the first or second-line treatment of PD-L1-positive advanced NSCLC. A post hoc exploratory analysis indicated that patients with tumors expressing PD-L1 at a level of 50% may experience improved clinical benefit with the combination therapy compared to those with PD-L1 at a level below 50%. However, the treatment had limited activity in previously treated EGFR-mutant NSCLC.<br /><br />Toxicities reported with the combination therapy were manageable and consistent with previous reports. A phase 3 trial comparing cabozantinib plus atezolizumab to docetaxel in NSCLC patients previously treated with immunotherapy and platinum-based chemotherapy has finished enrollment.<br /><br />The study enrolled a total of 59 patients across both cohorts. The patients received cabozantinib at a dose of 40mg once daily and atezolizumab at a dose of 1200mg every three weeks. Tumor assessments were conducted according to RECIST v1.1 by investigators every six weeks for the first year and every twelve weeks thereafter.<br /><br />The study found that the combination therapy resulted in a confirmed overall response rate of 28% in the first or second-line treatment cohort and 24% in the previously treated EGFR-mutant cohort. The disease control rate was 79% in the first or second-line treatment cohort and 82% in the previously treated EGFR-mutant cohort. The median progression-free survival was 4.7 months in the first or second-line treatment cohort and 2.7 months in the previously treated EGFR-mutant cohort. The median overall survival was 14.7 months in the first or second-line treatment cohort and 12.0 months in the previously treated EGFR-mutant cohort.<br /><br />In conclusion, cabozantinib plus atezolizumab showed moderate clinical activity in PD-L1-positive advanced NSCLC in the first or second-line treatment. However, the combination therapy had limited activity in previously treated EGFR-mutant NSCLC. The toxicities associated with the treatment were manageable, and a phase 3 trial comparing the combination therapy to docetaxel has finished enrollment.

Asset Subtitle

Joel W. Neal

Meta Tag

Speaker Joel W. Neal

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

IASLC 2022 World Conference on Lung Cancer

cabozantinib

atezolizumab

non-small cell lung cancer

NSCLC

PD-L1 positive

immunotherapy naive

EGFR-mutant

combination therapy

clinical activity