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523 Phase III double-blind randomized placebo controlled trial of atezolizumab in combination with carboplatin and paclitaxel in women with advanced/recurrent endometrial carcinoma: the Asian cohort of AtTEnd/ENGOT-EN7 trial
  1. Shin Nishio1,
  2. Beatriz Pardo2,
  3. Emma Hudson3,
  4. Eliana Rulli4,
  5. Yoland Antill5,
  6. Chulmin Lee6,
  7. Manuela Rabaglio7,
  8. Florian Heitz8,
  9. Katharina Leitner9,
  10. Chyong-Huey Lai10,
  11. Sara Uggeri4,
  12. Luis Manso11,
  13. Kenichi Harano12,
  14. Karen Allan13,
  15. Yeh Chen Lee14,
  16. Germana Tognon15,
  17. Stefania Canova16,
  18. Maria Cristina Petrella17,
  19. Angiolo Gadducci18 and
  20. Nicoletta Colombo19
  1. 1Kurume University School of Medicine, Kurume, Japan
  2. 2Catalan Institute of Oncology. Hospitalet de Llobregat, Barcelona, Spain
  3. 3Velindre Cancer Centre, Velindre NHS Trust, Cardiff, UK
  4. 4Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
  5. 5Peninsula Health, Monash University, Melbourne, Australia
  6. 6Cha University Ilsan Medical Center, Goyang, South Korea
  7. 7INSELSPITAL, University Hospital Bern, Bern, Switzerland
  8. 8Evang. Kliniken Essen-Mitte gGmbH, Essen, Germany
  9. 9Medical University Innsbruck, Innsbruck, Austria
  10. 10Chang Gung Memorial Hospital, Linkou branch, Taoyuan, Taiwan
  11. 11Hospital 12 de Octubre, Madrid, Spain
  12. 12National Cancer Center Hospital East, Kashiwa, Japan
  13. 13Cancer Research UK Glasgow Clinical Trials Unit, School of Cancer Sciences, University of Glasgow, Glasgow, UK
  14. 14NHMRC Clinical Trials Centre, Sydney University, Sydney, Australia
  15. 15ASST Spedali Civili di Brescia, Brescia, Italy
  16. 16Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
  17. 17Oncologia Medica Ginecologica – Azienda Ospedaliera Careggi, Firenze, Italy
  18. 18University of Pisa, Department of Clinical and Experimental Medicine, Division of Gynaecological and Obstetrics, Pisa, Italy
  19. 19Department of Gynecology, European Institute of Oncology, IEO, IRCCS, Milan, Italy

Abstract

Introduction/Background AtTEnd is a phase III randomized international academic trial showing the efficacy of atezolizumab in addition to standard carboplatin and paclitaxel (CP) in patients (pts) with advanced/recurrent endometrial cancer. The potential for differences of efficacy based on ethnicity is unknown.

Methodology In this post hoc analysis, we analyzed differences in the efficacy of atezolizumab in combination with CP and as maintenance vs CP alone comparing Asian cohort (AC) to non-Asian cohort (nAC).

Results From Oct 2018 to Jan 2022, 549 pts were randomized and included in the primary analysis, of these, 112 (20%) were of Asian ethnicity. AC in comparison with nAC showed a lower median age (63 vs. 67 years), a lower BMI (23.1 vs. 28.7), a better performance status (performance status of 0: 82% vs 66%), a lower prevalence of mismatch repair (MMR) deficient tumors (20% vs 24%) and a higher prevalence of PD-L1 positive pts (68.2% vs 38.8%). Forty-five percent of AC was enrolled as newly diagnosed metastatic compared to 30% of nAC and in this population primary surgery was performed in 82% of AC vs. 42% of nAC. In the recurrent population previous radiation therapy was administered to 16% of AC vs. 50% of nAC. Progression free survival (PFS) in placebo arm was longer in AC than in nAC (median PFS: 11.8 vs 8.5 months). PFS according to MMR status in AC and nAC is reported in figure 1. AC showed a higher occurrence of grade 3–5 adverse events (AE) (75% vs. 63%), serious AE (44% vs. 34%) and serious AE related to treatment (28% vs 17%).

Conclusion This analysis suggests that the addition of atezolizumab to standard CP chemotherapy can improve the PFS independently of Asian ethnicity in MMR deficient tumors, while in proficient its efficacy seems to be affected by ethnicity.

Disclosures The Mario Negri Institute for Pharmacological Research of Milan, Italy is the legal entity responsible for the governance, coordination, and execution of the study on behalf of Mario Negri Gynecologic Oncology (MaNGO) group. The study is funded by F. Hoffmann-La Roche Ltd. The trial protocol number is NCT03603184; 2018–001072-37.

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