Joel W. Neal, MD, PhD Discusses the Data on Cabozantinib and Atezolizumab Use in Advanced NSCLC

Joel W. Neal, MD, PhD, a medical oncologist and associate professor of medicine at Stanford Cancer Institute, sat down with CancerNetwork^® during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting to discuss key data from the phase 1b COSMIC-021 study (NCT03170960), assessing cabozantiniband atezolizumab (Tecentriq) in patients with advanced non-squamous non-small cell lung cancer (NSCLC). In addition to noting the encouraging clinical activity of the combination in this patient population, Neal highlighted that patients with an unknown PD-L1 status experienced a slightly higher response rate following treatment.

Transcript:

One interesting thing we looked at was the response rate [for] the combination of cabozantinib and atezolizumab; 19% of those 81 patients had tumors that responded. [Moreover], 76% of tumors actually had some degree of tumor shrinkage. We saw this as a very encouraging sign of clinical activity from the combination regimen.

Even though we didn't have PD-L1 status on all the tumors that were collected, of the PD-L1–negative tumors, there were lower response rates in the 10% range vs PD-L1–positive tumors. And most interesting to me, the PD-L1 unknown [tumors], the ones that hadn't been tested or [for which] we don't have central tissue to retest, actually had a slightly higher response rate and seemed to have better outcomes. There was some effect by PD-L1. It was interesting because I would have thought that the first-line use of immunotherapy would have minimized any effect from the PD-L1 being high or low.

Reference

Neal JW, Santoro A, Viteri A, et al. Cabozantinib (C) plus atezolizumab (A) or C alone in patients (pts) with advanced non–small cell lung cancer (aNSCLC) previously treated with an immune checkpoint inhibitor (ICI): results from Cohorts 7 and 20 of the COSMIC-021 study. J Clin Oncol 2022;40 (suppl 16):abstr9005. doi:10.1200/JCO.2022.40.16_suppl.9005