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NCT02657434

A Study of Atezolizumab in Combination With Carboplatin or Cisplatin + Pemetrexed Compared With Carboplatin or Cisplatin + Pemetrexed in Participants Who Are Chemotherapy-Naive and Have Stage IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC) (IMpower 132)

Completed Phase 3 Results posted Last updated 21 November 2023
What this trial tests

Phase 3 trial testing Atezolizumab in Non-Small Cell Lung Cancer in 578 participants. Completed in 13 December 2022.

Timeline
30 April 2016
Primary endpoint
18 July 2019
13 December 2022

Quick facts

Lead sponsorHoffmann-La Roche
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment578
Start date30 April 2016
Primary completion18 July 2019
Estimated completion13 December 2022
Sites183 locations across Italy, Japan, Malaysia, Taiwan, Ireland, South Korea, Netherlands, Russia

Drugs / interventions tested

Conditions studied

Sponsor

Hoffmann-La Roche — full company profile →

Who can join

18 and older, any sex, with Non-Small Cell Lung Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression Free Survival (PFS) as Assessed by the Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Primary · Randomization up to approximately 39 months

PFS is defined as the time from randomization to the first occurrence of disease progression as determined by the investigator using RECIST v1.1 or death from any cause, whichever occurred first.

GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)5.24.3 – 5.6
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed7.76.7 – 8.5
Overall Survival (OS) Primary · Randomization up to approximately 39 months

OS is defined as time from randomization to death from any cause.

GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)13.611.0 – 15.7
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed17.513.2 – 19.6
Overall Survival Rate at Year 1 Secondary · Year 1

The Overall Survival Rate at the 1-year landmark time point is defined as the probabilities that participants are alive 1-year after randomization.

GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)55.0449.21 – 60.87
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed59.7254.02 – 65.41
Overall Survival Rate Year 2 Secondary · Year 2

The Overall Survival Rate at the 2-year landmark time point is defined as the probabilities that participants are alive 2-years after randomization.

GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)34.0128.40 – 39.62
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed39.1333.44 – 44.81
Percentage of Participants With an Objective Response (Complete Response [CR] or Partial Response [PR]) Assessed by the Investigator Using RECIST V1.1 Secondary · Randomization up to approximately 25 months

An objective response is defined as either an unconfirmed CR or a PR, as determined by the investigator using RECIST v1.1. Objective Response Rate is defined as the proportion of patients who had an objective response.

Responders
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)37.4
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed51.7
Non-Responders
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)62.6
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed48.3
Duration of Response (DOR) as Determined by the Investigator Using RECIST v1.1 Secondary · Randomization up to approximately 25 months

DOR is defined as the time interval from the date of the first occurrence of a CR or PR (whichever status is recorded first) until the first date that progressive disease or death is documented, whichever occurs first.

GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)6.44.4 – 7.6
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed9.56.9 – 12.2
Change From Baseline in Patient-Reported Lung Cancer Symptoms as Assessed by European Organization for the Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire-Core 30 (QLQ-C30) Symptom Score Secondary · Baseline up to 3 and 6 months after disease progression or loss of clinical benefit (up to approximately 25 months)

EORTC QLQ-C30 is a validated and reliable self-report measure that consists of 30 questions that assess five aspects of patient functioning (physical, emotional, role, cognitive, and social), three symptom scales (fatigue, nausea and vomiting, pain), global health/quality of life, and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). EORTC QLQ-C30 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for

Dyspnoea: Week 3
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-1.95± 23.97
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-1.39± 25.17
Dyspnoea: Week 6
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-1.23± 23.16
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-4.71± 26.66
Dyspnoea: Week 9
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)0.20± 26.34
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-6.33± 26.62
Dyspnoea: Week 12
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-0.91± 27.57
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-3.39± 29.10
Dyspnoea: Week 15
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-1.67± 28.92
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-2.44± 28.73
Dyspnoea: Week 18
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-2.12± 24.85
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-3.44± 30.43
Dyspnoea: Week 21
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-5.67± 29.61
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-2.89± 31.83
Dyspnoea: Week 24
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-2.75± 28.74
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-2.45± 31.85
Change From Baseline in Patient-Reported Lung Cancer Symptoms as Assessed by EORTC Quality-of-Life Lung Cancer Module (QLQ-LC13) Symptom Score Secondary · Baseline up to 3 and 6 months after disease progression or loss of clinical benefit (up to approximately 25 months)

The EORTC QLQ-LC13 module incorporates one multiple item scale to assess dyspnea and a series of single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. The EORTC QLQ-LC13 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life); however, a high score for a symptom scale or ite

Coughing: Week 3
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-2.50± 25.37
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-3.41± 26.90
Coughing: Week 6
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-3.57± 27.20
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-9.82± 26.50
Coughing: Week 9
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-1.85± 24.43
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-8.29± 31.37
Coughing: Week 12
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-3.91± 28.46
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-10.71± 31.66
Coughing: Week 15
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-6.33± 30.39
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-11.53± 29.05
Coughing: Week 18
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-4.00± 26.97
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-11.63± 27.92
Coughing: Week 21
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-6.00± 27.78
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-10.50± 30.76
Coughing: Week 24
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-4.81± 28.05
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-10.03± 33.08
Change From Baseline in Patient-Reported Lung Cancer Symptoms as Reported Using the Symptoms in Lung Cancer (SILC) Scale Score Secondary · Baseline up to 3 and 6 months after disease progression or loss of clinical benefit (up to approximately 25 months)

Change from baseline per SILC scale will be analyzed for each lung cancer symptoms scores. SILC questionnaire comprises 3 individual symptoms \& are scored at individual symptom level, thus have a dyspnea score, chest pain score, \& cough score. There are a total of 9 questions in SILC questionnaire, each question has a minimum value of 0 \& maximum value of 4. Each individual symptom score is calculated as average of responses for symptom items. 'Chest pain' score is mean of question 1 \& 2, 'Cough' score is mean of question 3 \& 4 and 'Dyspnea' score is mean of question 5 to 9 in SILC questi

Chest Pain: Week 1
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)0.20± 0.83
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed0.30± 0.88
Chest Pain: Week 2
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-0.01± 0.88
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed0.21± 0.85
Chest Pain: Week 3
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-0.05± 0.92
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed0.06± 0.95
Chest Pain: Week 4
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)0.03± 0.91
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed0.03± 0.93
Chest Pain: Week 5
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-0.02± 0.93
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-0.01± 0.88
Chest Pain: Week 6
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)-0.05± 0.88
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-0.02± 0.92
Chest Pain: Week 7
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)0.07± 1.00
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-0.04± 1.00
Chest Pain: Week 8
GroupValue95% CI
Arm B (Carboplatin or Cisplatin + Pemetrexed)0.03± 0.94
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed-0.07± 1.02
Minimum Observed Serum Atezolizumab Concentration (Cmin) Secondary · Predose (Prd; 0 hour [h]) on D1 of Cy 2,3,4,8,16 (Cy length=21 days) and thereafter on D1 of every 8th cycle (up to approximately 25 months)

Minimum observed serum atezolizumab concentration (Cmin) prior to infusion at selected cycles (Arm A)

Cy2D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed69.8± 32.3
Cy3D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed115± 51.5
Cy4D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed151± 69.9
Cy8D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed221± 101
Cy16D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed234± 86.7
Cy24D1
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed257± 95.1
Treatment Discontinuation Visit
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed129± 93.1
Day 120 Post Last Dose
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed13.4± 19.4
Maximum Observed Serum Atezolizumab Concentration (Cmax) Secondary · Day 1 of Cycle 1 (Cycle length=21 days)

Maximum observed serum atezolizumab concentration (Cmax) after infusion (Arm A)

GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed403± 118
Plasma Concentrations for Carboplatin in Arm A(Atezolizumab + Carboplatin or Cisplatin + Pemetrexed) Secondary · Prd (0 h), 5-10 minutes (mins) before end of carboplatin infusion (infusion duration=1-2 h), 1 h post-infusion on D1 of Cy1,3 (Cy length=21 days)
Cy1D1 Predose
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + PemetrexedNA± NA
Cy1D1 Before End of Infusion
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed14900± 4260
Cy1D1 Post Infusion
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed12800± 4470
Cy3D1 Predose
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed220± 83.8
Cy3D1 Before End of Infusion
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed17900± 4390
Cy3D1 Post Infusion
GroupValue95% CI
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed13900± 4080

Adverse events — posted to ClinicalTrials.gov

Time frame: From the first study drug to the data cutoff date: 13 December 2022 (up to approximately 80 months).. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Arm B (Carboplatin or Cisplatin + Pemetrexed)
Serious: 91/274 (33%)
Deaths: 189/286
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed
Serious: 149/291 (51%)
Deaths: 190/292

Serious adverse events (186 terms)

ReactionSystemArm B (Carboplatin or Cisp…Arm A (Atezolizumab + Carb…
PNEUMONIAInfections and infestations
FEBRILE NEUTROPENIABlood and lymphatic system disorders
PYREXIAGeneral disorders
ANAEMIABlood and lymphatic system disorders
THROMBOCYTOPENIABlood and lymphatic system disorders
DIARRHOEAGastrointestinal disorders
PNEUMONITISRespiratory, thoracic and mediastinal disorders
VOMITINGGastrointestinal disorders
RESPIRATORY TRACT INFECTIONInfections and infestations
URINARY TRACT INFECTIONInfections and infestations
ASTHENIAGeneral disorders
PANCYTOPENIABlood and lymphatic system disorders
ABDOMINAL PAINGastrointestinal disorders
SEPSISInfections and infestations
DEHYDRATIONMetabolism and nutrition disorders
CEREBROVASCULAR ACCIDENTNervous system disorders
PULMONARY EMBOLISMRespiratory, thoracic and mediastinal disorders
NEUTROPENIABlood and lymphatic system disorders
GENERAL PHYSICAL HEALTH DETERIORATIONGeneral disorders
CELLULITISInfections and infestations
INFLUENZAInfections and infestations
ALANINE AMINOTRANSFERASE INCREASEDInvestigations
BLOOD CREATININE INCREASEDInvestigations
NEUTROPHIL COUNT DECREASEDInvestigations
PLATELET COUNT DECREASEDInvestigations
Other adverse events (50 terms — click to expand)

ReactionSystemArm B (Carboplatin or Cisp…Arm A (Atezolizumab + Carb…
ANAEMIABlood and lymphatic system disorders
NAUSEAGastrointestinal disorders
CONSTIPATIONGastrointestinal disorders
ASTHENIAGeneral disorders
DECREASED APPETITEMetabolism and nutrition disorders
FATIGUEGeneral disorders
DIARRHOEAGastrointestinal disorders
PYREXIAGeneral disorders
VOMITINGGastrointestinal disorders
ALANINE AMINOTRANSFERASE INCREASEDInvestigations
ASPARTATE AMINOTRANSFERASE INCREASEDInvestigations
NEUTROPENIABlood and lymphatic system disorders
NEUTROPHIL COUNT DECREASEDInvestigations
OEDEMA PERIPHERALGeneral disorders
ARTHRALGIAMusculoskeletal and connective tissue disorders
DYSPNOEARespiratory, thoracic and mediastinal disorders
COUGHRespiratory, thoracic and mediastinal disorders
RASHSkin and subcutaneous tissue disorders
BACK PAINMusculoskeletal and connective tissue disorders
THROMBOCYTOPENIABlood and lymphatic system disorders
PLATELET COUNT DECREASEDInvestigations
STOMATITISGastrointestinal disorders
HEADACHENervous system disorders
BLOOD CREATININE INCREASEDInvestigations
WHITE BLOOD CELL COUNT DECREASEDInvestigations
PRURITUSSkin and subcutaneous tissue disorders
DYSGEUSIANervous system disorders
INSOMNIAPsychiatric disorders
WEIGHT DECREASEDInvestigations
DIZZINESSNervous system disorders
MUCOSAL INFLAMMATIONGeneral disorders
PAIN IN EXTREMITYMusculoskeletal and connective tissue disorders
CHEST PAINGeneral disorders
HYPOKALAEMIAMetabolism and nutrition disorders
DRY SKINSkin and subcutaneous tissue disorders
HYPOMAGNESAEMIAMetabolism and nutrition disorders
EPISTAXISRespiratory, thoracic and mediastinal disorders
HYPOTHYROIDISMEndocrine disorders
LACRIMATION INCREASEDEye disorders
CONJUNCTIVITISInfections and infestations

Most-reported serious reactions: PNEUMONIA, FEBRILE NEUTROPENIA, PYREXIA, ANAEMIA, THROMBOCYTOPENIA, DIARRHOEA, PNEUMONITIS, VOMITING.

Data from ClinicalTrials.gov NCT02657434 adverse events section.

Sponsor's own description

This is a randomized, Phase III, multicenter, open-label study designed to evaluate the safety and efficacy of atezolizumab in combination with cisplatin or carboplatin + pemetrexed compared with treatment with cisplatin or carboplatin + pemetrexed in participants who are chemotherapy-naive and have Stage IV non-squamous NSCLC. Eligible participants will be randomized by a 1:1 ratio into 2 groups: Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed) and Arm B (Carboplatin or Cisplatin + Pemetrexed). The study will be conducted in two phases: Induction Phase and Maintenance Phase.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Immune checkpoint inhibitors: recent progress and potential biomarkers.
    Darvin P, Toor SM, Sasidharan Nair V, Elkord E. · · 2018 · cited 1495× · PMID 30546008 · DOI 10.1038/s12276-018-0191-1
  2. PD-1 and PD-L1 Checkpoint Signaling Inhibition for Cancer Immunotherapy: Mechanism, Combinations, and Clinical Outcome.
    Alsaab HO, Sau S, Alzhrani R, Tatiparti K, et al · · 2017 · cited 1206× · PMID 28878676 · DOI 10.3389/fphar.2017.00561
  3. Lung cancer immunotherapy: progress, pitfalls, and promises.
    Lahiri A, Maji A, Potdar PD, Singh N, et al · · 2023 · cited 737× · PMID 36810079 · DOI 10.1186/s12943-023-01740-y
  4. Improvement of the anticancer efficacy of PD-1/PD-L1 blockade via combination therapy and PD-L1 regulation.
    Wu M, Huang Q, Xie Y, Wu X, et al · · 2022 · cited 336× · PMID 35279217 · DOI 10.1186/s13045-022-01242-2
  5. Combining Immune Checkpoint Inhibitors With Conventional Cancer Therapy.
    Yan Y, Kumar AB, Finnes H, Markovic SN, et al · · 2018 · cited 163× · PMID 30100909 · DOI 10.3389/fimmu.2018.01739
  6. Association of Immune-Related Adverse Events With Efficacy of Atezolizumab in Patients With Non-Small Cell Lung Cancer: Pooled Analyses of the Phase 3 IMpower130, IMpower132, and IMpower150 Randomized Clinical Trials.
    Socinski MA, Jotte RM, Cappuzzo F, Nishio M, et al · · 2023 · cited 148× · PMID 36795388 · DOI 10.1001/jamaoncol.2022.7711
  7. Current state of immunotherapy for non-small cell lung cancer.
    Malhotra J, Jabbour SK, Aisner J. · · 2017 · cited 147× · PMID 28529902 · DOI 10.21037/tlcr.2017.03.01
  8. Immune Checkpoint Inhibitors for Lung Cancer Treatment: A Review.
    Onoi K, Chihara Y, Uchino J, Shimamoto T, et al · · 2020 · cited 137× · PMID 32384677 · DOI 10.3390/jcm9051362

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