WCLC 2025 - Posters & ePosters-P1.11.32 Quality of Life Outcomes from the Phase 3 Study of Atezolizumab + Bevacizumab and Chemotherapy (ATTLAS, KCSG-LU19-04) in EGFR/ALK- Mutated NSCLC

P1.11.32 Quality of Life Outcomes from the Phase 3 Study of Atezolizumab + Bevacizumab and Chemotherapy (ATTLAS, KCSG-LU19-04) in EGFR/ALK- Mutated NSCLC

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The Phase 3 ATTLAS trial evaluated quality of life (QoL) outcomes in patients with EGFR- or ALK-mutated non–small-cell lung cancer (NSCLC) who had progressed after tyrosine kinase inhibitor therapy. The study compared a combination regimen of atezolizumab, bevacizumab, paclitaxel, and carboplatin (ABCP), followed by maintenance with atezolizumab plus bevacizumab, against standard chemotherapy with pemetrexed plus carboplatin or cisplatin (PC), followed by pemetrexed maintenance. Previous results showed ABCP significantly improved objective response rates (69.5% vs. 41.9%) and median progression-free survival (8.48 vs. 5.62 months).<br /><br />In this QoL analysis of 225 patients (151 ABCP, 74 PC), health-related QoL was assessed using EORTC QLQ-C30 and QLQ-LC13 questionnaires at baseline and multiple timepoints up to 24 weeks. Compliance rates were high (>70%) throughout treatment, and baseline QoL scores were comparable between groups.<br /><br />Both treatment arms showed gradual improvement in global health status/quality of life (GHS/QoL) over 24 weeks, with no statistically significant differences between ABCP and PC. The ABCP arm demonstrated more consistent improvements in emotional and role functioning, while physical function improved modestly. Although ABCP led to more chemotherapy-related toxicities such as peripheral neuropathy and alopecia, cancer-related symptoms like coughing, dyspnea, and hemoptysis improved steadily and more markedly compared to PC.<br /><br />Median time to deterioration in GHS/QoL did not differ significantly between arms (HR 1.318, p=0.1595). Overall, despite some treatment-related toxicities, quality of life in the ABCP arm was maintained and not significantly worse than with PC. The findings suggest that ABCP can provide survival benefits while preserving patient-reported QoL when toxicities are appropriately managed.<br /><br />This study supports the use of atezolizumab plus bevacizumab and chemotherapy as a viable option post-TKI failure in EGFR/ALK-mutated NSCLC, offering improved clinical outcomes without compromising overall quality of life.

Asset Subtitle

Eun Joo Kang

Meta Tag

Speaker Eun Joo Kang

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

Phase 3 ATTLAS trial

EGFR-mutated NSCLC

ALK-mutated NSCLC

atezolizumab

bevacizumab

paclitaxel

carboplatin

quality of life

tyrosine kinase inhibitor failure

chemotherapy comparison