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. 2020 Jun 16;9(1):1774314. doi: 10.1080/2162402X.2020.1774314

Table 2.

Characteristics of included studies.

Author, year,
trial name,
NCT
Therapy line
Study design,
phase
Funding/Support
Recruiting
Period
Countries Follow-up N total randomized Key inclusion criteria
Primary outcome(s)
Intervention
N randomized
Comparison
N randomized
ATEZOLIZUMAB              
Fehrenbacher et al. 201640
POPLAR
NCT01903993
Second-line
therapy
Randomized,
controlled,
open-label,
phase 2
F. Hoffmann-La Roche/Genentech
August 2013 – March 2014 61 academic medical centers,
13 countries, Europe and North America
Median:
Atezolizumab: 14.8 months
Docetaxel:
15.7 months
287 Key inclusion criteria:
  • NSCLC with progression after platinum-based CHT

  • ECOG status of 0 or 1

  • Measurable disease

  • Adequate hematological and end-organ function


Primary endpoints:
  • Overall survival in the intention-to-treat population and PD-L1 subgroups

Atezolizumab 1200 mg
every 3 weeks
N = 144
Docetaxel 75 mg/m2 of BSA
every 3 weeks
N = 143
Rittmeyer et al. 201748
Fehrenbacher et al. 201841
OAK
NCT02008227
Second-line
therapy
Randomized,
controlled,
open-label,
phase 3
F. Hoffmann-La Roche/Genentech
March 2014 –
April 2015
194 academic or community oncology centers, 31 countries, Europe, North and South America, New Zealand, and Asia Median:
21 months
1225
(secondary efficacy population)
850
(primary efficacy population)
Key inclusion criteria:
  • Stage IIIB or IV squamous or nonsquamous NSCLC

  • ECOG status of 0 or 1

  • 1–2 previous cytotoxic chemotherapy regimens

  • Patients with EGFR mutations or an ALK fusion oncogene were additionally required to have received previous tyrosine kinase inhibitor therapy


Primary endpoints:
  • Overall survival

Atezolizumab 1200 mg
every 3 weeks
N = 425 (primary efficacy population)
N = 613 (secondary efficacy population)
Docetaxel 75 mg/m2 of BSA
every 3 weeks
N = 425 (primary efficacy population)
N = 612 (secondary efficacy population)
West et al.201950
IMpower130
NCT02367781
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
F. Hoffmann-La Roche/Genentech
April 2015 –
February 2017
131 centers,
8 countries,
North America, Europe and Israel
Median: (wild-type population)a
Atezolizumab plus Chemotherapy:
18.5 months
Chemotherapy:
19.2 months
724
Wild-type population:a
679
Key inclusion criteria:
  • Stage IV nonsquamous NSCLC

  • ECOG status of 0 or 1

  • No previous chemotherapy for stage IV disease


Primary endpoints:
  • Overall survival

  • Progression-free survival

Atezolizumab 1200 mg
every 3 weeks
+ carboplatin at an AUC of 6 mg/mL per minute every 3 weeks
+ nab-paclitaxel 100 mg/m2 of BSA every week
for four or six 21-day cycles
N = 483
N = 451 (wild-type population)a
Carboplatin at an AUC of 6 mg/mL per minute every 3 weeks
+ nab-paclitaxel 100 mg/m2 of BSA every week
for four or six 21-day cycles
N = 240
N = 228 (wild-type population) a
Socinski et al. 201849
IMpower150
NCT02366143
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
F. Hoffmann-La Roche/Genentech
March 2015 –
December 2016
240 sites, 26 countries, Australia, Asia, Europe, and North and South America Median:
(wild-type population)a
ABCP:
15.4 months
BCP:
15.5 months
1202
Wild-type population:a
1040
Key inclusion criteria:
  • Previously untreated stage IV or recurrent metastatic nonsquamous NSCLC

  • ECOG status of 0 or 1

  • Patients with EGFR or ALK genomic alterations if they had disease progression with or unacceptable side effects from treatment with at least one approved tyrosine kinase inhibitor


Primary endpoints:
  • Overall survival

  • Progression-free survival

ABCP:
Atezolizumab 1200 mg
+ bevacizumab 15 mg/kg BW
+ carboplatin at an AUC of 6 mg/mL per minute
+ paclitaxel 200 mg/m2 of BSA
(175 mg/m2 for Asian patients)
for four or six 21-day cycles
N = 400
N = 356 (wild-type population)a
ACP:
Atezolizumab 1200 mg
+ carboplatin at an AUC of 6 mg/mL per minute
+ paclitaxel 200 mg per m2 of BSA
(175 mg per m2 for Asian patients)
for four or six 21-day cycles
N = 402
N = 348 (wild-type population)a
BCP:
Bevacizumab 15 mg/kg BW
+ carboplatin at an AUC of 6 mg/mL per minute for four or six 21-day cycles
+ paclitaxel 200 mg per m2 of BSA
(175 mg/m2 for Asian patients)
N = 400
N = 336 (wild-type population)a
DURVALUMAB            
Antonia et al. 201722
Antonia et al. 201836
Gray et al. 201926
PACIFIC
NCT02125461
First-line
therapy
(consolidation after
radiochemotherapy)
Randomized,
double-blind,
placebo-controlled, phase 3
Astra Zeneca
May 2014 –
April 2016
Australia, Asia, Europe, North and South America, and South Africa Antonia et al. 2017:22
Median:
14.5 months
Antonia et al. 2018:36
Median:
25.2 months
Gray et al. 2019:26
Median:
33.3 months
713 Key inclusion criteria:
  • Histologically or cytologically documented stage III, locally advanced, unresectable NSCLC

  • Patients had received two or more cycles of platinum-based chemotherapy concurrent with definitive radiotherapy

  • No disease progression after this therapy

  • WHO performance status of 0 or 1

  • Life expectancy of 12 weeks or longer


Primary endpoints:
  • Overall survival

  • Progression-free survival

Durvalumab 10 mg/kg BW
every 2 weeks for up to 12 months
N = 476 (
Placebo
every 2 weeks for up to 12 months
N = 237
NIVOLUMAB              
Wu et al. 201951
CheckMate 078
NCT02613507
Second-line
therapy
Randomized,
controlled,
open-label,
phase 3
Bristol-Myers Squibb
December 2015 – November 2016 32 hospitals and cancer/medical centers,
China, Russia, Singapore
Median:
Nivolumab: 10.4 months
Docetaxel:
8.8 months
504 Key inclusion criteria:
  • Patients with stage IIIB or IV or recurrent squamous or nonsquamous NSCLC progressing during or after one previous platinum-based doublet chemotherapy regime

  • ECOG status of 0 or 1


Primary endpoint:
  • Overall survival

Nivolumab 3 mg/kg BW
every 2 weeks
N = 338
Docetaxel 75 mg/m2 of BSA
every 3 weeks
N = 166
Borghaei et al. 201537
CheckMate 057
NCT01673867
Second-line
therapy
Randomized,
controlled,
open-label,
phase 3
Bristol-Myers Squibb
November 2012 – December 2013 Europe and North and South America Minimum:
13.2 months
582 Key inclusion criteria:
  • Previously untreated stage IIIB or IV nonsquamous NSCLC

  • No activating EGFR mutations or ALK receptor tyrosine kinase gene translocations

  • ECOG status of 0 or 1


Primary endpoint:
  • Overall response rate

Nivolumab 3 mg/kg BW
every 2 weeks
N = 292
Docetaxel 75 mg/m2 of BSA
every 3 weeks
N = 290
Brahmer et al. 201538
CheckMate 017
NCT01642004
Second-line
therapy
Randomized,
controlled,
open-label,
phase 3
Bristol-Myers Squibb
October 2012 – December 2013 Australia, Europe, and North and South America Minimum:
11 months
272 Key inclusion criteria:
  • Patients with stage IIIB or IV squamous cell NSCLC who had disease recurrence after one prior platinum containing regimen

  • ECOG status of 0 or 1


Primary endpoint:
  • Overall survival

Nivolumab 3 mg/kg BW
every 2 weeks
N = 135
Docetaxel 75 mg/m2 of BSA
every 3 weeks
N = 137
Carbone et al. 201739
CheckMate 026
NCT02041533
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
Bristol-Myers Squibb
March 2014 –
April 2015
Australia, Asia, Europe, and North and South America Median:
13.5 months
541 Key inclusion criteria:
  • Histologically confirmed squamouscell or nonsquamous stage IV or recurrent NSCLC

  • ECOG status of 0 or 1

  • No previous systemic anti-cancer therapy as primary therapy for advanced or metastatic disease

  • PD-L1 expression level ≥1


Primary endpoint:
  • Progression-free survival among patients with a PD-L1 expression level of ≥5%

Nivolumab 3 mg/kg BW
every 2 weeks
N = 271
Platinum-based doublet CHT
every 3 weeks for 4 to 6 cycles:
carboplatin + pemetrexed,
cisplatin + pemetrexed,
carboplatin + gemcitabine,
cisplatin + gemcitabine, or
carboplatin + paclitaxel
N = 270
Hellmann et al. 201824
Hellmann et al. 201923
CheckMate 227
NCT02477826
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
Bristol-Myers Squibb
August 2015 – November 2016 Europe, North and South America, Australia, Asia, and Africa Minimum:
29.3 months
1739
PD-L1 expression of ≥1%:
1189
PD-L1 expression of <1%:
550
Key inclusion criteria:
  • Histologically confirmed squamous or nonsquamous stage IV or recurrent NSCLC

  • No previous systemic anticancer therapy as primary therapy for advanced or metastatic disease

  • ECOG status of 0 or 1


Primary endpoints:
  • Overall survival in a patient population selected on the basis of the PD-L1 expression level

  • Progression-free survival in a patient population on the basis of the tumor mutational burden

PD-L1 expression of ≥1%:
Nivolumab 3 mg/kg BW every 2 weeks
+ ipilimumab 1 mg/kg every 6 weeks
N = 396
or
Nivolumab 240 mg every 2 weeks
N = 396
PD-L1 expression of <1%:
Nivolumab 3 mg/kg BW every 2 weeks
+ ipilimumab 1 mg/kg BW every 6 weeks
N = 187
or
Nivolumab 360 mg every 3 weeks
+ platinum-doublet CHT based on histologic tumor type
every 3 weeks or up to four cycles
N = 177
PD-L1 expression of ≥1%:
Platinum-doublet CHT based on histologic tumor type
every 3 weeks for up to four cycles
N 397
PD-L1 expression of <1%:
Platinum-doublet CHT based on histologic tumor type
every 3 weeks for up to four cycles
N = 186
PEMBROLIZUMAB              
Herbst et al. 201643
KEYNOTE-010
NCT01905657
Second-line
therapy
Randomized,
controlled,
open-label,
phase 2/3
Merck & Co.
August 2013 – February 2015 202 academic centers, 24 countries, Africa, Australia, Asia, Europe, and North and South America Median:
13.1 months
1034 Key inclusion criteria:
  • Advanced NSCLC

  • Disease progression after two or more cycles of platinum-doublet chemotherapy

  • An appropriate tyrosine kinase inhibitor for those with an EGFR-sensitizing mutation or ALK gene rearrangement

  • ECOG status of 0 or 1

  • PD-L1 TPS >1%


Primary endpoints:
  • Overall survival in the total population and in patients with TPS>50%

  • Progression-free survival in the total population and in patients with TPS>50%

Pembrolizumab 2 mg/kg BW
every 3 weeks
N = 345
Pembrolizumab 10 mg/kg BW
every 3 weeks
N = 346
Docetaxel 75 mg per m2 of BSA
every 3 weeks
N = 343
Mok et al. 201945
KEYNOTE-042
NCT02220894
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
Merck Sharp & Dohme
December 2014 – March 2017 213 centers,
32 countries,
North and South America, Europe, Asia and South Africa
Median:
12.8 months
1274 Key inclusion criteria:
  • Previously untreated locally advanced or metastatic NSCLC

  • ECOG status of 0 or 1

  • No EGFR mutation or ALK translocation

  • PD-L1 TPS ≥1%

  • Life-expectancy 3 months or longer


Primary endpoints:
  • Overall survival in patients with PD-L1 TPS ≥50%, ≥20% or ≥1%

Pembrolizumab 200 mg every 3 weeks for up to 35 cycles
N = 637
Platinum-based CHT
of the investigator’s choice for 4–6 cycles:
carboplatin at an AUC of 5–6 mg/mL/min
+ paclitaxel 200 mg/m2 of BSA or pemetrexed 500 mg/m2
N = 637
Reck et al. 201647
Reck et al. 201927
KEYNOTE-024
NCT2142738
First-line
therapy
Randomized,
controlled,
open-label,
phase 3
Merck & Co.
September 2014 – October 2015 142 sites, 16 countries, Australia, Europe, and North America Reck et al. 2016:
Median:
11.2 months
Reck et al. 2019:
Median:
25.2 months
305 Key inclusion criteria:
  • Stage IV NSCLC

  • No sensitizing EGFR mutations or ALK translocations

  • No previous systematic therapy for metastatic disease

  • ECOG status of 0 or 1

  • Life expectancy of at least 3 months

  • PD-L1 tumor proportion score of 50% or more


Primary endpoint:
  • Progression-free survival

Pembrolizumab 200 mg
every 3 weeks for 35 cycles
N = 154
Platinum-based CHT
for 4 to 6 cycles:
carboplatin + pemetrexed,
cisplatin + pemetrexed,
carboplatin + gemcitabine,
cisplatin + gemcitabine, or
carboplatin + paclitaxel
N = 151
Paz-Ares et al. 201846
KEYNOTE-407
NCT02775435
First-line
therapy
Randomized,
controlled,
double-blind,
phase 3
Merck Sharp & Dohme
August 2016 – December 2017 125 sites, 17 countries, Australia, Europe, and North and Central America, Asia Median:
7.8 months
559 Key inclusion criteria:
  • Stage IV squamous NSCLC

  • ECOG status of 0 or 1

  • No previous chemotherapy for metastatic disease


Primary endpoints:
  • Overall survival

  • Progression-free survival

Pembrolizumab 200 mg every 3 weeks for up to 35 cycles
+ carboplatin at an AUC of 6 mg/mL
+ paclitaxel 200 mg/m2 of BSA or nab-paclitaxel 100 mg/m2 of BSA
for the first 4 cylces
N = 278
Placebo
for up to 35 cycles
+ carboplatin at an AUC of 6 mg/mL
+ paclitaxel 200 mg/m2 of BSA or nab-paclitaxel 100 mg/m2 of BSA
for the first 4 cylces
N = 281
Langer et al. 201644
Borghaei et al. 201925
KEYNOTE-021
NCT02039674
First-line
therapy
Randomized,
controlled,
open-label,
phase 2
Merck & Co.
November 2014 – January 2016 26 medical centers, 2 countries, Taiwan and USA Langer et al. 2016:
Median:
10.6 months
Borghaiei et al. 2019:
Median:
23.9 months
123 Key inclusion criteria:
  • Nonsquamous stage IIIB or IV NSCLC

  • No previous systemic treatment for stage IIIB or IV NSCLC

  • Absence of targetable EGFR mutations or ALK translocations

  • ECOG status of 0 or 1


Primary endpoint:
  • Objective response rate

Pembrolizumab 200 mg
+ Platinum-based doublet CHT:
carboplatin + pemetrexed
every 3 weeks for 4 cycles
N = 60
Platinum-based doublet CHT:
carboplatin + pemetrexed
for 4 cycles
N = 63
Gandhi et al. 201842
KEYNOTE-189
NCT02578680
First-line
therapy
Randomized,
controlled,
double-blind,
phase 3
Merck & Co.
February 2016 – March 2017 126 sites, 16 countries, Europe, North America, Australia, Asia, and Japan Median:
10.5 months
616 Key inclusion criteria:
  • Metastatic nonsquamous NSCLC without sensitizing EGFR or ALK mutations

  • No previous systematic therapy for systematic disease

  • ECOG status of 0 or 1


Primary endpoints:
  • Overall survival

  • Progression-free survival

Pembrolizumab 200 mg
every 3 weeks for 35 cycles
+ Platinum-based CHT:
four cycles of the investigator’s choice of IV cisplatin (75 mg/m2 of BSA) or carboplatin (AUC, 5 mg per ml per minute) plus pemetrexed (500 mg/m2), all administered IV every 3 weeks,
N = 410
Placebo
every 3 weeks for up to 35 cycles
+ Platinum-based CHT:
four cycles of the investigator’s choice of IV cisplatin (75 mg/m2 of BSA) or carboplatin (AUC, 5 mg per ml per minute) plus pemetrexed (500 mg per m2), all administered IV every 3 weeks, N = 206

Abbreviations: ABCP = atezolizumab plus bevacizumab plus carboplatin plus paclitaxel; ACP = atezolizumab plus carboplatin plus paclitaxel; ALK = anaplastic lymphoma kinase; AUC = area under the concentration−time curve; BSA = body surface area; BCP = bevacizumab plus carboplatin plus paclitaxel; BW = body weight; CHT = chemotherapy; ECOG = Eastern Cooperative Oncology Group; EGFR = epidermal growth factor receptor; IV = intravenously; ITT = intention-to-treat; N = number of patients; NCT = National Clinical Trial; NR = not reported; NSCLC = non–small cell lung cancer; PD-L1 = programmed death ligand-1; mg = milligram; ml = milliliter; kg = kilogram; TPS = tumor proportion score; WHO = World Health Organization

aWild-type genotype: patients with no EGFR or ALK genomic alterations