Patients Report Better RCC Outcomes for Atezolizumab + Bevacizumab

Atezolizumab plus bevacizumab was associated with less interference with daily function and quality of life than sunitinib among patients with renal cell carcinoma (RCC), according to a study of patient-reported outcomes (PROs) from the IMmotion151 study (abstract 4511). The findings were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.

IMmotion151 met its co-primary endpoint of progression-free survival (PFS), “demonstrating improved PFS for atezolizumab plus bevacizumab over sunitinib in patients with [programmed death ligand 1] PD-L1–positive disease,” noted lead study author Bernard Escudier, MD, of the Institut Gustave Roussy in Villejuif, France. “PROs further support the positive benefit-risk ratio of atezolizumab plus bevacizumab vs sunitinib as a first-line treatment option for metastatic RCC.”

All PROs favored atezolizumab plus bevacizumab over sunitinib, which included milder patient-reported symptoms, less functional impairment, a delay in meaningful deterioration of daily functioning, fewer bothersome treatment toxicities, and better health-related quality of life (HRQOL). HRQOL is a measure of the overall effect of cancer and its treatment on a patient, including disease symptoms, treatment toxicities, and patient function and well-being.

Patients treated with atezolizumab plus bevacizumab reported less pronounced worsening of their HRQOL than patients taking sunitinib.

Time to meaningful deterioration in patient daily functioning was delayed among patients receiving atezolizumab plus bevacizumab compared with those on sunitinib (median time to symptom interference, 11.3 months vs 4.3 months; hazard ratio, 0.56; 95% CI, 0.46–0.68).

“Baseline scores were similar, indicating no symptom interference or mild symptom interference [in daily functioning],” Escudier explained. “Patients treated with atezolizumab plus bevacizumab had less interference of symptoms with their day-to-day life at most visits compared with patients treated with sunitinib.”

Although the investigator-assessed PFS endpoint in the intent-to-treat (ITT) population was met, PFS by independent review for the ITT and the PD-L1–positive populations were not, noted Toni K. Choueiri, MD, of the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston.

“IMmotion151 has one of the most complete quality-of-life/PROs datasets for immunotherapy combinations available in RCC,” Choueiri said. “Seventeen disease and treatment-related symptoms improved, with 12 of the 17 being of clinical importance.”