First-line atezolizumab versus single-agent chemotherapy for NSCLC in patients not eligible for a platinum-containing regimen

At least 40% of NSCLC patients have ECOG performance status ≥ 2 and/or substantial comorbidities, resulting in ineligibility for platinum-based doublet chemotherapy (PDC) and most first-line trials. The multinational phase 3 IPSOS trial evaluated first-line atezolizumab versus single-agent chemotherapy (vinorelbine or gemcitabine) for NSCLC in patients ineligible for first-line PDC. With a median follow-up of 41.0 months, the atezolizumab group had improved OS versus chemotherapy (stratified HR 0.78; p=0.028), with a consistent benefit across subgroups. Two-year OS was 24.3% versus 12.4%; ORR was 16.9% versus 7.9%; and median duration of response was 14.0 months versus 7.8 months.