Durable benefit with atezolizumab in some advanced urothelial cancer patients
medwireNews: Updated results from the phase 3 IMvigor211 trial indicate that some patients with advanced urothelial cancer may derive a long-term benefit from atezolizumab after progression on platinum-based chemotherapy.
As previously reported by medwireNews, the primary analysis of the randomized controlled trial did not show a significant improvement in overall survival (OS) with atezolizumab (n=467) versus physician’s choice of single-agent chemotherapy (n=464).
However, at a median follow-up of 33 months, the OS rate at 24 months was 23% for the atezolizumab group and 13% for the chemotherapy group, with corresponding rates at 30 months of 18% and 10%.
The results were similar in subgroup analyses by PD-L1 expression levels on tumor-infiltrating immune cells, with numerically higher 24- and 30-month OS rates with atezolizumab than chemotherapy among patients with expression levels of less than 1% (23 vs 11% and 18 vs 9%, respectively), those with levels of 1% or more (22 vs 14% and 18 vs 10%), and those with levels of at least 5% (33 vs 18% and 29 vs 17%).
“Safety findings were consistent with the primary analysis, with no new signals detected,” write Michiel van der Heijden (Netherlands Cancer Institute, Amsterdam) and co-investigators.
They conclude in European Urology: “Our findings suggest the potential for long-term survival in this setting and support the recommended use of atezolizumab in prior platinum-treated patients with [metastatic urothelial carcinoma] regardless of PD-L1 status.”
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