- Compared with docetaxel, second- or third-line atezolizumab prolonged time to development of new symptomatic brain lesions in patients with advanced NSCLC and a history of brain metastasis.
- Atezolizumab also improved OS vs docetaxel in patients with no history of brain metastasis.
Why this matters
- Up to 40% of patients with advanced NSCLC develop brain metastases.
- 850 patients with advanced NSCLC received atezolizumab (n=425) or docetaxel (n=425) in the randomized, phase 3 OAK trial.
- Funding: F. Hoffmann-La Roche Ltd.
- ~14% of patients in each arm had a history of asymptomatic, treated brain metastases.
- Atezolizumab patients with a history of brain metastasis had lower odds of developing new brain lesions by 2 years (HR, 0.38; P=.0239).
- In patients with no brain metastases history, better median OS with atezolizumab vs docetaxel (13.2 vs 9.3 months; HR, 0.74; P=.0007).
- In patients with a history of brain metastases, OS was better with atezolizumab vs docetaxel, although not significant (16.0 vs 11.9 months; HR, 0.74; P=.1633).
- Fewer treatment-related adverse events (AEs), serious AEs, and treatment-related neurologic AEs with atezolizumab than with docetaxel.
- Variable frequency in follow-up brain scans.