WCLC 2025 - Posters & ePosters-EP.11.08 Comparison of Efficacy and Safety of Combination Therapy With Atezolizumab and Chemotherapy in Non-Small Cell Lung Cancer

EP.11.08 Comparison of Efficacy and Safety of Combination Therapy With Atezolizumab and Chemotherapy in Non-Small Cell Lung Cancer

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This retrospective multi-center study in Japan compared the efficacy and safety of two combination immunochemotherapy regimens—ACnP (carboplatin + nab-paclitaxel + atezolizumab) and ABCP (carboplatin + paclitaxel + bevacizumab + atezolizumab)—for treating non-small cell lung cancer (NSCLC), particularly in patients with renal dysfunction or resistance to EGFR tyrosine kinase inhibitors.<br /><br />Key endpoints assessed included overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse event profiles. Patient data from May 2018 to December 2023 across six Japanese medical centers were analyzed.<br /><br />Results showed no significant difference in ORR (ACnP 55.0% vs. ABCP 47.9%) or DCR (ACnP 85.0% vs. ABCP 85.4%), nor in dose reduction frequency. However, subgroup analyses adjusted by inverse probability of treatment weighting revealed that ABCP was preferable for patients with liver or brain metastases and those harboring EGFR mutations, likely due to higher VEGF expression in these subgroups which is targeted by bevacizumab. ABCP patients demonstrated better PFS and OS in these subsets.<br /><br />In contrast, ACnP was found to be safer and more effective for elderly patients, those with poor performance status, and non-adenocarcinoma histology. ACnP patients experienced statistically fewer hematological toxicities such as neutropenia, as well as less skin rash and peripheral neuropathy. The study notes a high nab-paclitaxel skip rate (63.4%) within ACnP but cites literature supporting superior survival in older patients treated with nab-paclitaxel regimens due to better tolerability.<br /><br />In conclusion, ABCP is favored for NSCLC patients with brain/liver metastases or EGFR mutations due to VEGF targeting, while ACnP offers a safer, well-tolerated alternative for elderly or frailer patients, balancing efficacy with reduced toxicity. This tailored approach may optimize treatment selection in advanced NSCLC.

Asset Subtitle

Taichi Isobe

Meta Tag

Speaker Taichi Isobe

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

non-small cell lung cancer

NSCLC

immunochemotherapy

ACnP regimen

ABCP regimen

EGFR mutations

VEGF targeting

renal dysfunction

elderly patients

treatment efficacy and safety