WCLC 2025 - Posters & ePosters-P1.07.51 Safety and Tolerability of Adjuvant Atezolizumab in Pd-L1>50% NSCLC Patients: Real-World Data From the Italian ATLAS Registry

P1.07.51 Safety and Tolerability of Adjuvant Atezolizumab in Pd-L1>50% NSCLC Patients: Real-World Data From the Italian ATLAS Registry

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This retrospective, multicenter real-world study from the Italian ATLAS registry evaluated the safety and tolerability of adjuvant atezolizumab in 132 patients with resected stage IB–IIIA non-small cell lung cancer (NSCLC) exhibiting high PD-L1 expression (≥50%). Patients had undergone surgery and adjuvant chemotherapy prior to receiving atezolizumab. The median patient age was 65, predominantly male (65.2%), mainly current/former smokers (90.9%), with ECOG performance status 0 or 1 in most cases. Histologically, 62.1% had adenocarcinoma, and 34.1% harbored KRAS mutations. Stage distribution was primarily IIB (40.2%) and IIIA (43.9%). Median follow-up was 15.7 months; at data cutoff, 54% remained on treatment, receiving a median 12.5 cycles.<br /><br />The safety profile revealed treatment-related adverse events (TRAEs) consistent with previous clinical trial data, such as those from the IMpower010 trial, which established improved disease-free survival with adjuvant atezolizumab and manageable safety in this setting. Grade 3 TRAEs were significantly more frequent in patients with ECOG PS 1 compared to PS 0 (29.4% vs. 7.4%, p=0.001) and in those without prior toxicities during adjuvant chemotherapy (24.4% vs. 3.7%, p=0.001). These findings underscore the need for careful monitoring in patients with lower performance status or less chemotherapy toxicity history.<br /><br />This study addresses a gap in real-world safety data for adjuvant atezolizumab outside of clinical trials, demonstrating that the treatment is generally well tolerated in routine clinical practice among resected NSCLC patients with high PD-L1 expression. The data support the feasibility and manageable safety of integrating atezolizumab as adjuvant therapy in this patient population.

Asset Subtitle

Maria Lucia Reale

Meta Tag

Speaker Maria Lucia Reale

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

adjuvant atezolizumab

non-small cell lung cancer

NSCLC

PD-L1 expression

real-world study

Italian ATLAS registry

treatment-related adverse events

ECOG performance status

KRAS mutations

IMpower010 trial