Prospects and progress of atezolizumab in non-small cell lung cancer

ABSTRACT

Introduction: Immunotherapy has recently come to the forefront of oncology treatment as a potential means of combating cancer by restoring the body’s adaptive cancer-immunity cycle. Atezolizumab is a monoclonal antibody agent that specifically targets programmed death ligand 1 (PD-L1), a key molecule in the cancer-immunity pathway, to block binding to its receptors PD-1 and B7.1.

Areas covered: This review covers the role of atezolizumab in the treatment of non-small-cell lung cancer (NSCLC). Several studies have reported promising efficacy in this indication. The phase II FIR and BIRCH studies evaluated atezolizumab monotherapy across different lines of therapy in NSCLC selected by PD-L1 expression status. The randomized POPLAR and OAK trials of atezolizumab versus docetaxel in previously treated NSCLC reported improved efficacy in the atezolizumab arm. Several ongoing studies yet to report data are also described and treatment-related adverse events are discussed.

Expert opinion: Clinical trials have shown that atezolizumab has a favorable risk-benefit ratio compared with standard chemotherapy in second-line treatment of non-oncogene-driven advanced NSCLC. Promising response rates and survival over 2 years has been reported in the first-line setting; however, more research is needed in this setting and in evaluating combinatorial strategies to treat NSCLC.

KEYWORDS:

• Atezolizumab
• PD-L1
• NSCLC
• immunotherapy
• checkpoint inhibitors

Acknowledgments

Third-party medical writing assistance, under the direction from the authors, was provided by Joanna Musgrove, MRes, of Gardiner-Caldwell Communications, funded by F. Hoffmann-La Roche.

Declaration of interest

J Vansteenkiste was a speaker for F. Hoffmann La Roche. K Park was an advisor/consultant for F. Hoffmann‐La Roche. A Rittmeyer has received grants as an advisor or speaker by Roche–Genentech, Bristol-Myers Squibb, AstraZeneca, Eli Lilly and Company, Boehringer Ingelheim and Pfizer Inc. A Sandler is an employee of Roche–Genentech Ltd. A Spira was a speaker for Roche, has received clinical trial support by Roche and was a consultant for Clovis, AstraZeneca and Ariad. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Writing assistance was utilized in the production of this manuscript and funded by F. Hoffmann-La Roche.

Additional information

Funding

Medical writing was funded by F. Hoffmann-La Roche.