Resumen

Este es un ensayo clínico aleatorizado, de fase III, multicéntrico y abierto, diseñado para evaluar la seguridad y la eficacia de atezolizumab en combinación con cisplatino o carboplatino + pemetrexed en comparación con el tratamiento con cisplatino o carboplatino + pemetrexed en participantes sin tratamiento previo con quimioterapia que presentan cáncer de pulmón de células no pequeñas (CPNCP/NSCLC) no escamoso en estadio IV. Los participantes elegibles fueron aleatorizados en una proporción 1:1 en 2 grupos: Brazo A (atezolizumab + carboplatino o cisplatino + pemetrexed) y Brazo B (carboplatino o cisplatino + pemetrexed). El estudio se llevó a cabo en dos fases: fase de inducción y fase de mantenimiento.

Elegibilidad

Edad mínima: 18 YearsSexo: ALL

Criterios de inclusión

Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Histologically or cytologically confirmed, Stage IV non-squamous NSCLC. Participants with tumors of mixed non-small cell histology (i.e., squamous and non-squamous) are eligible if the major histological component appears to be non-squamous
No prior treatment for Stage IV non-squamous NSCLC. Participants with a sensitizing mutation in the epidermal growth factor receptor (EGFR) gene or with an anaplastic lymphoma kinase (ALK) fusion oncogene are excluded. Participants with unknown EGFR and ALK status require test results at screening from a local or central laboratory
Participants who have received prior neo-adjuvant, radiotherapy, adjuvant chemotherapy, or chemoradiotherapy with curative intent for non-metastatic disease must have experienced a treatment-free interval of at least 6 months from randomization since the last dose of chemotherapy and/or radiotherapy
Participants should submit a pre-treatment tumor tissue sample if available before or within 4 weeks after enrollment. If tumor tissue is not available, participants are still eligible
For participants enrolled in the extended China enrollment phase: current resident of mainland China, Hong Kong, or Taiwan and of Chinese ancestry
Measurable disease, as defined by RECIST v1.1
Adequate hematologic and end organ function
For women of childbearing potential: agreement to remain abstinent or use contraceptive methods that result in a failure rate of less than (\<) 1 percent (%) per year during the treatment period and for at least 5 months after the last dose of atezolizumab or 6 months after the last dose of cisplatin
For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm

Criterios de exclusión

Cancer-Specific Exclusions
Participants with a sensitizing mutation in the EGFR gene or an ALK fusion oncogene
Active or untreated central nervous system (CNS) metastases as determined by computed tomography (CT) or magnetic resonance imaging (MRI) evaluation during screening and prior radiographic assessments
Spinal cord compression not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for greater than or equal to (\>= 2) weeks prior to randomization
Leptomeningeal disease
Uncontrolled tumor-related pain
Uncontrolled or symptomatic hypercalcemia (greater than \[\>\] 1.5 millimole/Liter ionized calcium or calcium \>12 milligrams/deciliter or corrected serum calcium \>upper limit of normal)
Malignancies other than NSCLC within 5 years prior to randomization
Known tumor programmed death-ligand 1 (PD-L1) expression status from other clinical studies (e.g., participants whose PD-L1 expression status was determined during screening for entry into a study with anti-PD-1 or anti-PD L1 antibodies but were not eligible are excluded)
General Medical Exclusions:
History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
History of certain autoimmune disease
History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis
All participants will be tested for human immunodeficiency virus (HIV) prior to the inclusion into the study and HIV-positive participants will be excluded from the clinical study
Severe infections within 4 weeks prior to randomization
Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction or cerebrovascular accident within 3 months prior to randomization, unstable arrhythmias, or unstable angina
Illness or condition that may interfere with a participant's capacity to understand, follow, and/or comply with study procedures
Prior treatment with EGFR inhibitors or ALK inhibitors
Any approved anti-cancer therapy, including hormonal therapy within 21 days prior to initiation of study treatment
Prior treatment with cluster of differentiation 137 (CD137) agonists or immune checkpoint blockade therapies, anti-PD-1, and anti-PD-L1 therapeutic antibodies
Treatment with systemic immunostimulatory agents within 4 weeks prior to randomization
Treatment with systemic immunosuppressive medications
History of allergic reactions to cisplatin, carboplatin, or other platinum-containing compounds
Participants with hearing impairment (cisplatin)
Grade \>=2 peripheral neuropathy as defined by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0 criteria (cisplatin)
Creatinine clearance (CRCL) \<60 milliliters/minute (mL/min) for cisplatin or \<45 mL/min for carboplatin

Intervenciones

drug

Atezolizumab

Participants received IV infusion of 1200 mg atezolizumab on Day 1 q3w for 4 or 6 cycles (Cycle length=21 days) in induction dosing period and until disease progression on Day 1 q3w in the maintenance dosing period.

drug

Carboplatin

Participants received IV infusion of carboplatin on Day 1 q3w for 4 or 6 cycles (Cycle length=21 days) in induction dosing period with doses calculated using Calvart formula.

drug

Cisplatin

Participants received IV infusion of 75 mg/m\^2 cisplatin on Day 1 q3w for 4 or 6 cycles (Cycle length=21 days) in induction dosing period.

drug

Pemetrexed

Participants received IV infusion of 500 mg/m\^2 pemetrexed on Day 1 q3w for 4 or 6 cycles (Cycle length=21 days) in induction dosing period and until disease progression on Day 1 q3w in the maintenance dosing period.

Resumen

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

Atezolizumab

Carboplatin

Cisplatin

Pemetrexed

Ubicaciones

Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich

Fundacion Clinica Colombo

Clinica Viedma S.A.

Patrocinadores