The addition of the immunotherapy drug atezolizumab to bevacizumab and standard chemotherapy showed benefit in both progression-free survival (PFS) and duration of response in patients with pleural mesothelioma, according to findings from the phase III BEAT-meso trial.
The findings were presented by BEAT-meso study chair Sanjay Popat, PhD, FRCP, of the Royal Marsden Hospital NHS Foundation Trust in London, during an oral abstract session on June 3 at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. While the study did not meet its primary endpoint of overall survival, it demonstrated a significant benefit in both progression-free and overall survival in non-epithelioid mesothelioma patients.
“Recent trials have demonstrated improved overall survival with either combination nivolumab-ipilimumab or platinum pemetrexed-pembrolizumab over platinum pemetrexed chemotherapy alone, with larger relative effect seen in non-epithelioid subtypes,” Dr. Popat said. “Bevacizumab is immuno-modulatory, potentially synergizing with immune checkpoint inhibitors through a variety of different mechanisms, and the addition of bevacizumab to cisplatin-pemetrexed has been shown to improve overall survival over chemotherapy alone, again with a stronger relative impact in non-epithelioid cases.”
In BEAT-meso, an open-label, randomized two-arm, multicenter phase III trial, investigators sought to evaluate the efficacy, safety, and tolerability of treatment with atezolizumab-bevacizumab-carboplatin-pemetrexed (ABC) versus bevacizumab-carboplatin-pemetrexed (BC) in first-line unresectable pleural mesothelioma.
“In the ITT (intent-to-treat) population, a significant improvement for progression-free survival and duration of response for the ABC combination versus the BC combination did not translate to a significant improvement in overall survival; the overall survival was between 18.1 months and 20.5 months,” Dr. Popat said.
When looking at different histological subtypes, both progression-free survival and overall survival were greater in the ABC arm in non-epithelioid histology, he said. Further, he reported that patient-reported quality of life was not significantly different between the ABC and BC arms.
