IMpower150

一行要約

未治療 stage IV 非扁平 NSCLC への ABCP (Atezolizumab + Bevacizumab + Carbo + Paclitaxel) vs BCP の phase III。EGFR / ALK+ NSCLC subgroup でも benefit を示した唯一の IO+chemo 試験で、driver+ post-TKI での IO+chemo+anti-VEGF paradigm を確立。

試験デザイン

• 対象: 未治療 stage IV 非扁平 NSCLC、EGFR/ALK+ TKI 後の cross-over 含む、N=1202 (3-arm)
• Arm A: Atezolizumab + Carbo + Paclitaxel
• Arm B (ABCP): Atezolizumab + Bevacizumab + Carbo + Paclitaxel
• Arm C (BCP, control): Bevacizumab + Carbo + Paclitaxel
• Primary analysis: ITT-WT (EGFR/ALK 陰性) で B vs C

主要結果

• PFS (ITT-WT, B vs C) : HR 0.62, median 8.3 vs 6.8 mo
• OS (ITT-WT, B vs C) : HR 0.78, median 19.2 vs 14.7 mo
• EGFR/ALK+ subgroup (B vs C) : PFS HR 0.59、OS HR 0.61 (driver+ で benefit)
• Liver metastasis subgroup: HR 0.52 (poor prognostic で IO benefit 顕著)
• AE: Grade 3-4 56% vs 50% (IO 追加で増加)

臨床的意義

• EGFR / ALK+ NSCLC TKI 後 IO+chemo の唯一の prospective evidence
• Liver met 等 IO 不利 subset で anti-VEGF 併用で benefit 引き出し
• Anti-VEGF + IO の “vascular normalization → immune microenvironment” rationale 確立
• KEYNOTE-189 と異なる patient population coverage (EGFR/ALK+ subgroup の取り込み)

Open Questions

• ABCP vs IO+chemo (KEYNOTE-189) の selection: liver met / EGFR-TKI 後 / immune cold context での選好
• EGFR-TKI 後 1L IO+chemo+anti-VEGF: ATR-7 等の現代化
• 4-drug combination の毒性管理: 高齢 / PS 2 で simplification の試み
• Anti-VEGF + IO mechanism: vascular normalization の biomarker / monitoring

重要論文 Top 10

1. ★★★★★ Socinski et al. NEnglJMed 2018 — IMpower150 primary
2. LancetRespirMed-2019-Reck-Atezolizumab plus bevacizumab and chemotherapy in non-small-cell lung cancer IMpower150 final OS analysis — Final OS analysis
3. ★★★★ Gandhi et al. NEnglJMed 2018 — KEYNOTE-189 — parallel non-sq
4. ★★★★ Sandler et al. NEnglJMed 2006 — E4599 — Bev paradigm 起源
5. ★★★★ Nakagawa et al. LancetOncol 2019 — RELAY — EGFR+ + ramucirumab parallel

関連エンティティ

• 薬剤クラス: PD-L1-inhibitor (Atezolizumab), anti-VEGF-antibody (Bevacizumab), Platinum-chemotherapy / Taxane
• 関連試験: KEYNOTE-189 / E4599 / RELAY
• ドメイン: lung-cancer-treatment

関連論文

直近 30 件のみ表示中 (関連 59 件)。 全件は MOC ページ または Obsidian (source Markdown) から辿れます。

Basic-Others

• Rottenberg et al. NatRevCancer 2021 — The rediscovery of platinum-based cancer therapy

Basic-Tumor microenvironment

• Rahma et al. ClinCancerRes 2019 — The intersection between tumor angiogenesis and immune suppression
• Martin et al. NatRevClinOncol 2020 — Improving cancer immunotherapy using nanomedicines progress, opportunities and challenges

Clinical-Methodology

• Bruno et al. BrJCancer 2023 — Support to early clinical decisions in drug development and personalised medicine with checkpoint inhibitors using
• Bruno et al. ClinCancerRes 2023 — Tumor dynamic model-based decision support for phase IbII combination studies A retrospective assessment based on

Clinical-NSCLC-Driver negative

• Amrein et al. CancerImmunolImmunother 2021 — Chemotherapy negatively impacts the tumor immune microenvironment in NSCLC SAKK19-09 study
• Shimizu et al. CancerSci 2026 — Atezolizumab + chemotherapy in older patients with lung cancer in japan
• Marinelli et al. CancerTreatRev 2026 — PD-(l)1 containing rechallenge strategies in patients with advanced NSCLC previously treated with immunotherapy A
• Gridelli et al. ESMOOpen 2022 — First-line immunotherapy in advanced NSCLC patients with ECOG PS 2 results of an international expert Panel meeting b…
• Li et al. FrontImmunol 2026 — The application and challenges of immune checkpoint inhibitors in lung cancer therapy
• Rizvi et al. JAMAOncol 2020 — Durvalumab with or without tremelimumab vs standard chemotherapy in first-line treatment of metastatic non-small cell
• Socinski et al. JAMAOncol 2026 — Tiragolumab plus atezolizumab and chemotherapy for advanced nonsquamous non-small cell lung cancer the phase 3
• Jotte et al. JThoracOncol 2020 — Atezolizumab in combination with carboplatin and nab-paclitaxel in advanced squamous NSCLC (IMpower131) results from a
• Lantuejoul et al. JThoracOncol 2020 — Interobserver reliability of programmed cell death ligand-1 scoring using the VENTANA PD-L1 (SP263) assay in NSCLC
• Nishio et al. JThoracOncol 2021 — Atezolizumab plus chemotherapy for first-line treatment of nonsquamous NSCLC results from the randomized phase 3
• Socinski et al. JThoracOncol 2021 — IMpower150 final overall survival analyses for atezolizumab plus bevacizumab and chemotherapy in first-line metastatic
• Shiraishi et al. LungCancer 2026 — Final overall survival analysis of the APPLE study atezolizumab and platinum-pemetrexed with or without bevacizumab for
• Herbst et al. NEnglJMed 2020 — Atezolizumab for first-line treatment of PD-L1-selected patients with NSCLC

Clinical-NSCLC-EGFR

• Hastings et al. AnnOncol 2019 — EGFR mutation subtypes and response to immune checkpoint blockade treatment in non-small-cell lung cancer
• Watanabe et al. EurJCancer 2024 — A phase II study of atezolizumab with bevacizumab, carboplatin, and paclitaxel for patients with EGFR-mutated NSCLC
• Niu et al. FrontImmunol 2026 — Efficacy and mechanisms of immune checkpoint inhibitors in late-stage EGFR-mutated non-small cell lung cancer following
• HARMONi et al. JAMA 2026 — A-Bispecific antibody ivonescimab added to chemotherapy in EGFR-variant non-small cell lung cancer the HARMONi-A
• Nogami et al. JThoracOncol 2022 — IMpower150 final exploratory analyses for atezolizumab plus bevacizumab and chemotherapy in key NSCLC patient subgroups
• Kumagai et al. NatRevCancer 2021 — Antitumour immunity regulated by aberrant ERBB family signalling
• Zhao et al. NatRevClinOncol 2026 — Navigating the landscape of EGFR TKI resistance in EGFR-mutant NSCLC-mechanisms and evolving treatment approaches

Clinical-Others

• Roulleaux-Dugage et al. JImmunotherCancer 2026 — VEGF-A blockade overcomes liver metastases resistance to chemoimmunotherapy in patients with advanced non-squamous NSCLC

Clinical-SCLC

• Hao et al. CancerCommun(Lond) 2026 — Serplulimab plus chemotherapy, with or without HLX04, versus chemotherapy as first-line treatment for nonsquamous NSCLC

Clinical-Thymic

• Asao et al. ClinLungCancer 2023 — Study design and rationale for marble study A phase II trial of atezolizumab (MPDL3280A) plus carboplatin and

Clinical-irAE

• Socinski et al. JAMAOncol 2023 — Association of immune-related adverse events with efficacy of atezolizumab in patients with non-small cell lung cancer
• Govindan et al. JImmunotherCancer 2022 — Society for immunotherapy of cancer (SITC) clinical practice guideline on immunotherapy for the treatment of lung