Impact of the IMpower133 Trial in Small Cell Lung Cancer

Leora Horn, MD, global clinical head for Lung Cancer and Lung Cancer Strategy at AstraZeneca, discusses the importance of the Impower133 trial (NCT02763579) trial of carboplatin plus etoposide with or without atezolizumab (Tecentriq) in patients with small cell lung cancer.

According to Horn, Impower133 was a global phase 3 trial of chemotherapy with carboplatin plus etoposide with or without atezolizumab in untreated extensive-stage small cell lung cancer. Prior to this study, no real improvements in outcomes for this patient population had been made. IMpower133 marks the first time a checkpoint inhibitor has been successfully combined with chemotherapy in this patient population.

While there wasn’t a marked improvement in response rate, there was a significant improvement in overall and progression-free survival, according to Horn. Median overall survival improved from 10.3 to 12.3 months for patients with small cell lung cancer, leading to FDA approval of the combination.

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0:08 | IMpower133 was a global phase 3 trial that looked at chemotherapy with carboplatin plus etoposide with or without atezolizumab in patients with small cell lung cancer. I think a big part of this study, having been talked about so much is that for decades, we really had no improvements in outcomes for patients with small cell lung cancer. We would take every new agent that came along, add it to a platinum etoposide regimen,, and really didn't see a benefit. And this was the first positive study for patients with small cell lung cancer with a checkpoint inhibitor in combination with chemotherapy. And the initial data that came out showed that while response rate wasn't high, because it's sort of difficult to improve on a 60-plus percent response rate, there was a significant improvement in progression-free survival, there was also an improvement in overall survival, and the median overall survival went from 10.3 to 12.3 months for patients with small cell lung cancer. This led to an FDA approval for carboplatin plus etoposide with atezolizumab for patients with small cell lung cancer. And this really was a landmark study in that it was the first time in a long time that a new drug got approved for this indication.