Is the Oncology Community Too Accepting of Marketing Messages in Cancer Trials? A Close Look at IMpower010

Dr. Jack West, MD discussed the IMpower010 trial's adjuvant atezolizumab use, showing disease-free survival benefits for high PD-L1 patients, though the FDA approved it for a broader population; he highlighted concerns about biased presentation of results and urged careful data evaluation.

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Jack West
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Dr. Jack West,MD an associate professor in medical oncology at City of Hope Comprehensive Cancer Center in Los Angeles,

discussed a recent publication in the Annals of Oncology regarding the IMpower010 trial. The trial focused on the adjuvant use of atezolizumab and was initially presented by Dr. Heather Wakely and colleagues at ASCO 2021. The trial showed a statistically significant improvement in disease-free survival for patients with stage 2 to 3a resected non-small cell lung cancer and PD-L1 of 1% or higher who received adjuvant atezolizumab compared to placebo.


While the trial demonstrated benefits in disease-free survival, further analysis reveals that the benefit was limited to patients with high PD-L1 levels, not those with lower positive PD-L1 levels (1-49%). Despite this, the FDA approved adjuvant atezolizumab for the broader population of stage 2 to 3a patients with PD-L1 positivity, even though the overall survival benefit was not statistically significant.


In a recently published study, overall survival data were presented. The data indicated that while the trial's interim analysis showed a negative hazard ratio (0.71) for overall survival, it was more impressive for patients with high PD-L1 (hazard ratio of 0.43). However, Dr. West expressed concern about how the results were presented, highlighting that the positive aspect of the trial is magnified while the negative aspect is not adequately acknowledged.


Dr. West emphasized that while marketing messages may influence presentation, the scientific community should be cautious and thoroughly review data before endorsing a specific interpretation. He raised concerns about the lack of balanced representation of the trial's results, particularly in terms of patients with low PD-L1 levels who did not show significant overall survival benefit. He urged oncologists and researchers to critically evaluate and interpret study data rather than solely relying on marketing-friendly representations.