World Lung 2023 – Impower-151 can’t repeat Impower-150’s lung cancer success

Back in 2020 Roche had designed Impower-151 as a China-focused phase 3 study to address regional differences in patients’ genetic composition, most importantly higher EGFR mutation prevalence, versus the US registrational Impower-150 trial. Both studies concerned a combination of Tecentriq with Avastin and chemo in first-line non-squamous NSCLC, but ‘151 has failed to repeat the success of ‘150. World Lung today heard that Impower-151’s primary endpoint of investigator-assessed PFS didn’t back the triplet versus Avastin plus chemo alone, and neither did analyses of overall survival or remission rates. EGFR mutation status plays an important role in first-line NSCLC, and Tecentriq’s US label based on Impower-150 is notable for mandating no EGFR or Alk aberrations; in contrast the corresponding EU approval says EGFR or ALK mutants must only have failed targeted therapy, meaning that they could theoretically get Roche's combo while still harbouring a secondary mutation. Dr Caicun Zhou, from Tongji University School of Medicine, told World Lung that the ‘151 results were “inconsistent” with ‘150. However, baseline differences are the giveaway: 53% of the ‘151 population was EGFR or ALK positive, versus just 14% of that in Impower-150.

China anti-PD-(L)1 MAb approvals in 1st-line metastatic NSCLC

Source: OncologyPipeline & ApexOnco.