Clinical activity and molecular correlates of response to atezolizumab alone or in combination with bevacizumab versus sunitinib in renal cell carcinoma.

Abstract:

:We describe results from IMmotion150, a randomized phase 2 study of atezolizumab (anti-PD-L1) alone or combined with bevacizumab (anti-VEGF) versus sunitinib in 305 patients with treatment-naive metastatic renal cell carcinoma. Co-primary endpoints were progression-free survival (PFS) in intent-to-treat and PD-L1+ populations. Intent-to-treat PFS hazard ratios for atezolizumab + bevacizumab or atezolizumab monotherapy versus sunitinib were 1.0 (95% confidence interval (CI), 0.69-1.45) and 1.19 (95% CI, 0.82-1.71), respectively; PD-L1+ PFS hazard ratios were 0.64 (95% CI, 0.38-1.08) and 1.03 (95% CI, 0.63-1.67), respectively. Exploratory biomarker analyses indicated that tumor mutation and neoantigen burden were not associated with PFS. Angiogenesis, T-effector/IFN-γ response, and myeloid inflammatory gene expression signatures were strongly and differentially associated with PFS within and across the treatments. These molecular profiles suggest that prediction of outcomes with anti-VEGF and immunotherapy may be possible and offer mechanistic insights into how blocking VEGF may overcome resistance to immune checkpoint blockade.

journal_name

Nat Med

journal_title

Nature medicine

authors

McDermott DF,Huseni MA,Atkins MB,Motzer RJ,Rini BI,Escudier B,Fong L,Joseph RW,Pal SK,Reeves JA,Sznol M,Hainsworth J,Rathmell WK,Stadler WM,Hutson T,Gore ME,Ravaud A,Bracarda S,Suárez C,Danielli R,Gruenwald V,Ch

doi

10.1038/s41591-018-0053-3

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

749-757

issue

6

eissn

1078-8956

issn

1546-170X

pii

10.1038/s41591-018-0053-3

journal_volume

24

pub_type

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