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Research ArticleClinical Studies

Atezolizumab for EGFR-mutated Non-small Cell Lung Cancer Patients: An Observation Study in Ibaraki Group (ATTENTION-IBARAKI)

TOMOHIRO TAMURA, TAKESHI NUMATA, HIDETOSHI YANAI, RYOTA NAKAMURA, TOSHIHIRO SHIOZAWA, HIROKO WATANABE, SHINICHIRO OKAUCHI, NORIHIRO KIKUCHI, KUNIHIKO MIYAZAKI, SHIGEN HAYASHI, TAKAAKI YAMASHITA, KOICHI KURISHIMA, MASAHARU INAGAKI, HIROAKI SATOH, HIROICHI ISHIKAWA, TAKAYUKI KABURAGI, TAKEO ENDO, TORU SAKAMOTO and NOBUYUKI HIZAWA
Anticancer Research October 2023, 43 (10) 4583-4591; DOI: https://doi.org/10.21873/anticanres.16652
TOMOHIRO TAMURA
1Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan;
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TAKESHI NUMATA
2Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan;
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HIDETOSHI YANAI
2Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan;
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RYOTA NAKAMURA
2Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan;
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TOSHIHIRO SHIOZAWA
3Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan;
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HIROKO WATANABE
4Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan;
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SHINICHIRO OKAUCHI
5Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan;
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NORIHIRO KIKUCHI
6Division of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan;
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KUNIHIKO MIYAZAKI
7Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan;
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SHIGEN HAYASHI
8Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan;
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TAKAAKI YAMASHITA
9Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan;
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KOICHI KURISHIMA
10Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan;
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MASAHARU INAGAKI
11Division of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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HIROAKI SATOH
5Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan;
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  • For correspondence: hirosato@md.tsukuba.ac.jp
HIROICHI ISHIKAWA
10Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan;
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TAKAYUKI KABURAGI
1Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan;
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TAKEO ENDO
2Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan;
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TORU SAKAMOTO
4Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan;
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NOBUYUKI HIZAWA
3Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan;
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Abstract

Background/Aim: Atezolizumab, an anti-programed death-ligand 1 monoclonal antibody, targets programed death-ligand 1 expressed on cancer cells and antigen-presenting cells and is now commonly used in combination with chemotherapy. We conducted a study to clarify the efficacy of atezolizumab in epidermal growth factor receptor (EGFR)-mutated patients who are considered less responsive to immune checkpoint inhibitors. Patients and Methods: A retrospective review of patients with advanced non-small cell lung cancer (NSCLC) who received atezolizumab-containing therapy at 11 hospitals from April 2018 to March 2023 was performed. Results: Median progression-free survival and overall survival in 33 EGFR-mutated patients treated with atezolizumab monotherapy were 2.0 and 9.0 months, respectively, and those in 19 patients who received combined atezolizumab plus chemotherapy were 12.0 and 17.0 months, respectively. When comparing EGFR-mutated and EGFR-negative patients after propensity score matching, there were no significant differences in progression-free survival and overall survival between the two groups, whether atezolizumab monotherapy or combined atezolizumab plus chemotherapy. Among EGFR-mutated patients, being male was a significant favorable factor in both atezolizumab treatment groups. None of the EGFR-mutated patients had grade 5 immune-related adverse events. Conclusion: Efficacy of atezolizumab in EGFR-mutated NSCLC patients could be comparable to that for EGFR-negative patients. To prolong the survival of EGFR-mutated NSCLC patients, appropriate selection and sequencing of EGFR for tyrosine kinase inhibitors, as well as immune checkpoint inhibitors, anti-tumor agents, and anti-angiogenic agents are important.

Key Words:
  • Atezolizumab
  • epidermal growth factor receptor
  • progression-free survival
  • overall survival
  • immune-related adverse events
  • Received July 23, 2023.
  • Revision received August 20, 2023.
  • Accepted August 25, 2023.
  • Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 43 (10)
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Atezolizumab for EGFR-mutated Non-small Cell Lung Cancer Patients: An Observation Study in Ibaraki Group (ATTENTION-IBARAKI)
TOMOHIRO TAMURA, TAKESHI NUMATA, HIDETOSHI YANAI, RYOTA NAKAMURA, TOSHIHIRO SHIOZAWA, HIROKO WATANABE, SHINICHIRO OKAUCHI, NORIHIRO KIKUCHI, KUNIHIKO MIYAZAKI, SHIGEN HAYASHI, TAKAAKI YAMASHITA, KOICHI KURISHIMA, MASAHARU INAGAKI, HIROAKI SATOH, HIROICHI ISHIKAWA, TAKAYUKI KABURAGI, TAKEO ENDO, TORU SAKAMOTO, NOBUYUKI HIZAWA
Anticancer Research Oct 2023, 43 (10) 4583-4591; DOI: 10.21873/anticanres.16652

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Atezolizumab for EGFR-mutated Non-small Cell Lung Cancer Patients: An Observation Study in Ibaraki Group (ATTENTION-IBARAKI)
TOMOHIRO TAMURA, TAKESHI NUMATA, HIDETOSHI YANAI, RYOTA NAKAMURA, TOSHIHIRO SHIOZAWA, HIROKO WATANABE, SHINICHIRO OKAUCHI, NORIHIRO KIKUCHI, KUNIHIKO MIYAZAKI, SHIGEN HAYASHI, TAKAAKI YAMASHITA, KOICHI KURISHIMA, MASAHARU INAGAKI, HIROAKI SATOH, HIROICHI ISHIKAWA, TAKAYUKI KABURAGI, TAKEO ENDO, TORU SAKAMOTO, NOBUYUKI HIZAWA
Anticancer Research Oct 2023, 43 (10) 4583-4591; DOI: 10.21873/anticanres.16652
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Keywords

  • Atezolizumab
  • epidermal growth factor receptor
  • progression-free survival
  • overall survival
  • immune-related adverse events
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