Adjuvant atezolizumab after adjuvant chemotherapy in resected stage IB–IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial

Felip, Enriqueta; Altorki, Nasser K.; Zhou, Caicun; Csőszi, Tibor; Vynnychenko, Ihor; Goloborodko, Oleksandr; Luft, Alexander; Akopov, Andrey; Martinez-Martí, Alex; Kenmotsu, Hirotsugu; Chen, Yuh‐Min; Chella, Antonio; Sugawara, Shunichi; Voong, David; Wu, Fan; Yi, Jing; Deng, Yu; McCleland, Mark L.; Bennett, Elizabeth; Gitlitz, Barbara J.; Wakelee, Heather A.

doi:10.1016/s0140-6736(21)02098-5

Cited by 964 publications

(772 citation statements)

References 34 publications

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“…In the setting of early-stage NSCLC, the first reported phase 3 trial of adjuvant immunotherapy for early-stage NSCLC, MACRIT, had a negative result [ 24 ]. However, a recently published study, IMpower 010, showed that adjuvant atezolizumab significantly improved survival after adjuvant chemotherapy in patients with resected NSCLC compared to best supportive care [ 25 ]. Thus, adjuvant atezolizumab, following resection and platinum-based chemotherapy, has been approved for patients with stage II to IIIA NSCLC [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neoadjuvant and Adjuvant Immunotherapy in Early-Stage Non-Small-Cell Lung Cancer, Past, Present, and Future

Szeto

Shalata

Yakobson

et al. 2021

JCM

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Lung cancer is worldwide the most common malignancy. Standard of care treatments for early-stage non-small-cell lung cancer (NSCLC) include surgery and adjuvant chemotherapy. However, these patients continue to have poor prognosis due to systemic or local relapse. Immunotherapy has been considered as a novel approach to improve survival in patients with early-stage NSCLC. Since immune checkpoint inhibitors have transformed the treatment of advanced NSCLC, there is a growing interest in the role of immunotherapy in early-stage NSCLC. In this review, we summarize reported and ongoing clinical trials of immunotherapy in both neoadjuvant and adjuvant settings. We also highlight unaddressed issues in this field of research, such as the predictive markers, the optimal combination therapy, and the need for adjuvant immunotherapy. More studies are needed to optimize the treatment regimen of immunotherapy in patients with early-stage NSCLC.

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Section: Discussionmentioning

confidence: 99%

“…A total of 1280 patients, from 227 sites in 22 countries, were enrolled in this open-label phase III study [ 25 ]. All patients had completely resected NSCLC (stage IB–IIIA).…”

Section: Past Clinical Trials That Included Only Adjuvant Immunotherapy In Patients With Resected Nsclcmentioning

confidence: 99%

Neoadjuvant and Adjuvant Immunotherapy in Early-Stage Non-Small-Cell Lung Cancer, Past, Present, and Future

Szeto

Shalata

Yakobson

et al. 2021

JCM

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show abstract

“…Ultimately, pathologic assessment and genomic sequencing may prove complementary strategies, as pathologic assessment is performed routinely and at present is more cost-effective. However, as biomarker-directed therapies are increasingly becoming the standard-of-care even in early-stage NSCLC, 7 , 8 genomic assessment of MLTs will also become more common. At present, the IASLC guidelines include both clinical, histologic, and biomarker patterns in their criteria for identifying distinct primaries; 60 further studies in larger cohorts using standardized sequencing approaches will help further define how best to systematically incorporate clinical genomics into lung cancer staging.…”

Section: Clinical Applications Of Sequencing To Distinguish Between Primary and Secondary Nsclcsmentioning

confidence: 99%

“…Adjuvant systemic therapy after surgery plays an important role in improving disease-free and overall survival in patients with stage II or III tumors, and the roster of approved adjuvant therapies has recently expanded from platinum-based chemotherapies 3–6 to include adjuvant Osimertinib in EGFR mutated patients 7 and atezolizumab in patients with PD-L1 > 1%. 8 While adjuvant systemic therapy is considered the standard of care for resected stage II and III NSCLC, systemic therapy does not play a role for earlier stage NSCLC due to historic evidence demonstrating no benefit and in fact a trend toward harm in stage IA patients treated with chemotherapy. 6 Accurately determining cancer staging is therefore crucial for the appropriate management of NSCLC.…”

Section: Introductionmentioning

confidence: 99%

The Role of Whole Exome Sequencing in Distinguishing Primary and Secondary Lung Cancers

Zhang¹

2021

LCTT

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Non-small cell lung cancer (NSCLC) that presents with multiple lung tumors (MLTs) poses a challenge to accurate staging and prognosis. MLTs that arise as clonally related secondary metastases from a common primary are higher stage and often require adjuvant chemotherapy or may in fact be incurable stage IV lesions. Conversely, MLTs that represent distinct primaries have a better prognosis and may be overtreated if inappropriately classified as related secondaries. Historically, pathologic and radiographic criteria were used to distinguish between primary and secondary MLTs; however, the advent of genomic profiling has demonstrated limitations to these historic classification systems. In this review, we discuss the use of molecular profiling to distinguish between primary and secondary lung cancers, with a focus on the insights gleaned from whole exome sequencing (WES) analyses. While WES is not yet feasible in routine clinical practice, WES studies have helped elucidate the clonal relationship between primary and secondary lung cancers and provide important context for the application of targeted sequencing panel-based analyses.

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“…New drugs, including immune checkpoint inhibitors and targeted therapy, have changed the prognosis in a subset of patients with advanced NSCLC [1][2][3], and are now actively investigated in a number of trials with neoadjuvant and adjuvant regimens [11][12][13]. Immunotherapy with or without chemotherapy significantly improves survival of patients with advanced NSCLC depending on the programmed cell death ligand-1 (PD-L1) expression [14].…”

Section: Introductionmentioning

confidence: 99%

Safety of Surgery after Neoadjuvant Targeted Therapies in Non-Small Cell Lung Cancer: A Narrative Review

Marjański

Dziedzic

Kowalczyk

et al. 2021

IJMS

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New drugs, including immune checkpoint inhibitors and targeted therapy, have changed the prognosis in a subset of patients with advanced lung cancer, and are now actively investigated in a number of trials with neoadjuvant and adjuvant regimens. However, no phase III randomized studies were published yet. The current narrative review proves that targeted therapies are safe in neoadjuvant approach. Unsurprisingly, administration of therapy is related to an acceptable toxicity profile. Severe adverse events’ rate that rarely compromises outcomes of patients with advanced lung cancer is not that commonly accepted in early lung cancer as it may lead to missing the chance of curative surgery. Among those complications, the most important factors that may limit the use of targeted therapies are severe respiratory adverse events precluding the resection occurring after treatment with some anaplastic lymphoma kinase and rarely after epidermal growth factor receptor tyrosine kinase inhibitors. At this point, in the presented literature assessing the feasibility of neoadjuvant therapies with anaplastic lymphoma kinase and epidermal growth factor receptor tyrosine kinase inhibitors, we did not find any unexpected intraoperative events that would be of special interest to a thoracic surgeon. Moreover, the postoperative course was associated with typical rate of complications.

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Adjuvant atezolizumab after adjuvant chemotherapy in resected stage IB–IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial

Cited by 964 publications

References 34 publications

Neoadjuvant and Adjuvant Immunotherapy in Early-Stage Non-Small-Cell Lung Cancer, Past, Present, and Future

Neoadjuvant and Adjuvant Immunotherapy in Early-Stage Non-Small-Cell Lung Cancer, Past, Present, and Future

The Role of Whole Exome Sequencing in Distinguishing Primary and Secondary Lung Cancers

Safety of Surgery after Neoadjuvant Targeted Therapies in Non-Small Cell Lung Cancer: A Narrative Review

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