KEY TAKEAWAYS
- The APOLO phase II trial aimed to examine induction chemo-immunotherapy + chemo-radiotherapy and maintenance immunotherapy in patients with stage III NSCLC.
- Researchers suggested that induction chemo-immunotherapy with standard chemo-radiotherapy and atezolizumab may improve outcomes versus PACIFIC.
The standard treatment for unresectable stage III non-small cell lung cancer (NSCLC), chemo-radiotherapy followed by durvalumab (PACIFIC regimen), has limited efficacy. The APOLO trial explored a novel approach using induction chemo-immunotherapy followed by standard chemo-radiotherapy and atezolizumab maintenance.
Mariano Provencio and the team aimed to evaluate the efficacy and safety of induction chemo-immunotherapy followed by concurrent chemo-radiotherapy and maintenance atezolizumab in patients with unresectable stage III NSCLC.
This phase II trial enrolled patients with unresectable stage IIIA-IIIB-IIIC NSCLC. Patients received induction therapy with atezolizumab, carboplatin, and paclitaxel for 3 cycles. This was followed by concurrent chemo-radiotherapy for 3 cycles and then maintenance atezolizumab for 12 months. The primary endpoint was progression free survival (PFS) at 12 months.
The study included 38 patients in the intention to treat (ITT) population and 32 in the protocol population (PP) population. In the ITT analysis, the 12-month PFS was 68.4% (95% CI: 51.1-80.6%), and the 12-month overall survival (OS) was 86.8% (95% CI: 71.2-94.3%). The PP analysis demonstrated a 12-month PFS of 78.1% (95% CI: 59.5-88.9%) and a 12-month OS of 90.6% (95% CI: 73.6-96.8%). Treatment-related adverse events (TRAEs) were mainly grade 1/2.
The APOLO trial suggested that induction chemo-immunotherapy followed by standard chemo-radiotherapy and atezolizumab maintenance is a promising treatment strategy for unresectable stage III NSCLC, potentially offering superior outcomes compared to the historical PACIFIC regimen.
The trial was sponsored by Fundación GECP.
Source: https://cattendee.abstractsonline.com/meeting/20598/presentation/720
Clinical Trial: https://clinicaltrials.gov/study/NCT04776447
Provencio M, Campos B, Guirado M, et al. (2024). “APOLO: phase II trial of induction chemo-immunotherapy plus chemoradiotherapy and maintenance immunotherapy in stage III NSCLC.” Presented at: World Conference on Lung Cancer (WCLC); September 8, 2024; Singapore. September 9, 2024.
