In May, the European Commission extended the use of atezolizumab and osimertinib in non-small cell lung cancer, following the evaluation of alterations in molecular biomarkers

On May 5, the European Commission approved the anti-PD-L1 monoclonal antibody atezolizumab (Tecentriq, Roche) for first-line treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumours have high PD-L1 expression, with no EGFR activating mutations or ALK alterations.
This approval is based on the results of the phase 3 IMpower110 study, published on NEJM on October 2020.
This study showed that atezolizumab monotherapy improved overall survival (OS) by 7.1 months compared with chemotherapy (20.2 versus 13.1 months) in patients with stage IV NSCLC and with high PD-L1 expression, but without alterations (SNP, In/Del, rearrangements) of EGFR and ALK genes.

An updated analysis of the study results was presented at the World Conference on Lung Cancer 2020, last January, which confirmed the superiority of atezolizumab over chemotherapy in patients with high PD-L1 expression. In fact, after a median follow-up of 31.3 months, median OS in the atezolizumab arm was the same as observed in the previous analysis (20.2 months); in the chemotherapy arm, median OS was 14.7 months. Median progression-free survival (PFS) also improved in the atezolizumab arm compared with chemotherapy arm: 8.2 versus 5 months. Moreover, in this updated analysis, the anti-PD-L1 inhibitor continued to demonstrate improvements versus chemotherapy in terms of response to treatment. The ORR was 40.2% and 28.6% in the atezolizumab arm and in the chemotherapy arm respectively, whereas the median DOR was 38.9 months vs 8.3 months respectively.