A Study of Atezolizumab in Combination With Carboplatin or Cisplatin + Pemetrexed Compared With Carboplatin or Cisplatin + Pemetrexed in Participants Who Are Chemotherapy-Naive and Have Stage IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC) (IMpower 132)
Non-Small Cell Lung Cancer

About this trial
This is an interventional treatment trial for Non-Small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Histologically or cytologically confirmed, Stage IV non-squamous NSCLC. Participants with tumors of mixed non-small cell histology (i.e., squamous and non-squamous) are eligible if the major histological component appears to be non-squamous
- No prior treatment for Stage IV non-squamous NSCLC. Participants with a sensitizing mutation in the epidermal growth factor receptor (EGFR) gene or with an anaplastic lymphoma kinase (ALK) fusion oncogene are excluded. Participants with unknown EGFR and ALK status require test results at screening from a local or central laboratory
- Participants who have received prior neo-adjuvant, radiotherapy, adjuvant chemotherapy, or chemoradiotherapy with curative intent for non-metastatic disease must have experienced a treatment-free interval of at least 6 months from randomization since the last dose of chemotherapy and/or radiotherapy
- Participants should submit a pre-treatment tumor tissue sample if available before or within 4 weeks after enrollment. If tumor tissue is not available, participants are still eligible
- For participants enrolled in the extended China enrollment phase: current resident of mainland China, Hong Kong, or Taiwan and of Chinese ancestry
- Measurable disease, as defined by RECIST v1.1
- Adequate hematologic and end organ function
- For women of childbearing potential: agreement to remain abstinent or use contraceptive methods that result in a failure rate of less than (<) 1 percent (%) per year during the treatment period and for at least 5 months after the last dose of atezolizumab or 6 months after the last dose of cisplatin
- For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm
Exclusion Criteria:
Cancer-Specific Exclusions
- Participants with a sensitizing mutation in the EGFR gene or an ALK fusion oncogene
- Active or untreated central nervous system (CNS) metastases as determined by computed tomography (CT) or magnetic resonance imaging (MRI) evaluation during screening and prior radiographic assessments
- Spinal cord compression not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for greater than or equal to (>= 2) weeks prior to randomization
- Leptomeningeal disease
- Uncontrolled tumor-related pain
- Uncontrolled or symptomatic hypercalcemia (greater than [>] 1.5 millimole/Liter ionized calcium or calcium >12 milligrams/deciliter or corrected serum calcium >upper limit of normal)
- Malignancies other than NSCLC within 5 years prior to randomization
- Known tumor programmed death-ligand 1 (PD-L1) expression status from other clinical studies (e.g., participants whose PD-L1 expression status was determined during screening for entry into a study with anti-PD-1 or anti-PD L1 antibodies but were not eligible are excluded)
General Medical Exclusions:
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- History of certain autoimmune disease
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis
- All participants will be tested for human immunodeficiency virus (HIV) prior to the inclusion into the study and HIV-positive participants will be excluded from the clinical study
- Severe infections within 4 weeks prior to randomization
- Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction or cerebrovascular accident within 3 months prior to randomization, unstable arrhythmias, or unstable angina
- Illness or condition that may interfere with a participant's capacity to understand, follow, and/or comply with study procedures
Exclusion Criteria Related to Medications and Chemotherapy:
- Prior treatment with EGFR inhibitors or ALK inhibitors
- Any approved anti-cancer therapy, including hormonal therapy within 21 days prior to initiation of study treatment
- Prior treatment with cluster of differentiation 137 (CD137) agonists or immune checkpoint blockade therapies, anti-PD-1, and anti-PD-L1 therapeutic antibodies
- Treatment with systemic immunostimulatory agents within 4 weeks prior to randomization
- Treatment with systemic immunosuppressive medications
Exclusion Criteria Related to Chemotherapy:
- History of allergic reactions to cisplatin, carboplatin, or other platinum-containing compounds
- Participants with hearing impairment (cisplatin)
- Grade >=2 peripheral neuropathy as defined by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0 criteria (cisplatin)
- Creatinine clearance (CRCL) <60 milliliters/minute (mL/min) for cisplatin or <45 mL/min for carboplatin
Sites / Locations
- Los Angeles Hematology Oncology Medical Group
- St. Joseph Heritage Healthcare
- Stamford Hospital; BCC, MOHR
- Orlando Health Inc.
- Tallahassee Memorial Hospital
- Northside Hospital
- Ingalls Memorial Hospital
- Illinois Cancer Care
- HealthCare Research Network II, LLC - PPDS
- Fort Wayne Med Oncology & Hematology Inc
- Goshen Health System
- University of Kentucky; Markey Cancer Center
- University of Michigan
- CHI Health St. Francis
- Nebraska Methodist Hospital
- Montefiore Medical Center
- Swedish Cancer Institute
- Providence Portland Medical Center
- Gettysburg Cancer Center
- Allegheny Cancer Center
- Oncology Consultants PA
- Virginia Cancer Specialists (Fairfax) - USOR
- Peninsula Cancer Institute
- Blue Ridge Cancer Care
- University of Washington
- St. Vincent Hospital
- Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich
- Fundacion Clinica Colombo
- Centro de Investigacion; Clinica - Clinica Viedma S.A.
- St Vincent's Hospital Sydney
- Sydney Adventist Hospital; Clinical Trial Unit
- St George Hospital; Medical Oncology
- Redcliffe Hospital
- Mater Adult Hospital
- Royal Hobart Hospital
- Ballarat Health Services
- Peninsula and South Eastern Haematology and Oncology Group
- Barwon Health
- Klinikum Wels-Grieskirchen GmbH
- AZ Maria Middelares
- Clinique André Renard; Pneumologie
- AZ Delta (Campus Rumbeke), Apotheek
- Multiprofile Hospital for Active Treatment Serdika EOOD
- Health & Care SPA
- Sociedad de Investigaciones Medicas Ltda (SIM)
- Hospital Clinico Vina del Mar
- Beijing Friendship Hospital Affiliated of Capital University of Medical Science
- Beijing Cancer Hospital
- Hunan Cancer Hospital
- Changzhou First People's Hospital
- The First Affiliated Hospital of Guangzhou Medical University
- The First Affiliated Hospital of Medical School of Zhejiang University
- Sir Run Run Shaw Hospital Zhejiang University
- Anhui Provincial Hospital; 2F,Tumor chemotherapy Department
- Anhui Provincial Hospital; Respiratory Department
- Qilu Hospital
- Jiangsu Province Hospital (the First Affiliated Hospital With Nanjing Medical University)
- Shanghai Chest Hospital
- Zhongshan Hospital Fudan University
- First Hospital of China Medical University
- Tianjin Medical University Cancer Institute & Hospital
- Tianjin Medical University General Hospital
- Tongji Hospital Tongji Medical College Huazhong University of Science and Technology
- Tumor Center,Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Zhejiang Cancer Hospital
- Institut Sainte Catherine
- Hopital Louis Pradel; Pneumologie
- Centre Jean Perrin Centre Regional de Lutte Contre Le Cancer D auvergne
- Centre Hospitalier Intercommunal; Service de Pneumologie
- Polyclinique de Limoges - Site Chenieux; Oncologie Medicale
- Hopital Nord AP-HM
- Centre Regional de Lutte contre le Cancer Val d Aurelle - Paul Lamarque; Service d oncologie
- Centre Hospitalier de Mulhouse - Hopital Emile Muller
- Hopital d'Instruction des Armees de Begin
- Hopital d Instruction des Armees de Sainte Anne
- Veszprem Megyei Tudogyogyintezet
- Petz Aladar Megyei Oktato Korhaz
- Markusovszky Hospital
- Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz
- Tudogyogyintezet Torokbalint
- Mater Misecordiae University Hospital
- St James's Hospital
- Barzilai Medical Center
- Edith Wolfson Medical Center
- Rabin Medical Center
- Azienda Ospedaliero Universitaria di Parma
- Ospedale Santa Maria Delle Croci
- Istituto Nazionale Tumori Regina Elena
- Azienda Policlinico Umberto I
- Azienda Sanitaria Ospedaliera S Luigi Gonzaga; S.C.D.U. di Oncologia Toracica
- Presidio Ospedaliero Vito Fazzi; Unita Operativa Di Oncologia Medica
- Ospedale Casa Sollievo Della Sofferenza IRCCS
- Ospedale San Vincenzo Taormina :Divisione di Oncologia Medica
- Ospedale San Luca - USL2 Lucca
- National Hospital Organization Nagoya Medical Center
- National Cancer Center Hospital East
- Hiroshima University Hospital
- National Hospital Organization Asahikawa Medical Center
- National Hospital Organization Himeji Medical Center
- Kanazawa University Hospital
- Kagoshima University Hospital
- Kanagawa Cancer Center
- Tohoku University Hospital
- Niigata University Medical & Dental Hospital
- Osaka University Hospital
- Osaka Medical College Hospital
- Saga University Hospital
- Tokushima University Hospital
- Juntendo University Hospital
- Nippon Medical School Hospital
- Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital
- The Cancer Institute Hospital of JFCR
- NTT Medical Center Tokyo
- National Hospital Organization Yamaguchi - Ube Medical Center
- Seoul National University Hospital
- Asan Medical Center
- Samsung Medical Center
- Riga East Clinical University Hospital Latvian Oncology Centre
- Panevezys Hospital
- Advanced Medical and Dental Institute; Kompleks Klinikal
- Hospital Kuala Lumpur
- Amphia Ziekenhuis
- Haga Ziekenhuis
- Ziekenhuis Gelderse Vallei
- Ziekenhuis St. Jansdal
- Zuyderland Medisch Centrum - Sittard Geleen
- ETZ TweeSteden
- Hospital Nacional Cayetano Heredia
- Hospital Beatriz Angelo
- Unidade Local de Saude de Matosinhos SA
- Hospital CUF Porto; Servico de Imunoalergologia
- Medisprof SRL
- Spitalul Clinic Judetean de Urgenta Sf. Apostol Andrei Constanta
- Euroclinic Center of Oncology SRL
- Chelyabinsk Regional Clinical Oncology Dispensary
- Moscow City Oncology Hospital #62
- Regional Clinical Oncology Hospital
- Hospital General Universitario de Elche; Servicio de Oncologia
- Hospital Universitario Germans Trias i Pujol
- ICO L'Hospitalet; Servicio de oncologia medica
- Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
- Hospital de Mataro
- Onkologikoa; Ensayos Clinicos
- Centro Oncologico de Galicia COG; Medical Oncology
- Hospital Universitario Virgen de La Arrixaca; Servicio De Oncologia
- Clinica Universitaria de Navarra; Servicio de Oncologia
- Complejo Hospitalario de Navarra; Servicio de Oncologia
- Complejo Hospitalario Nuestra Senora de Valme
- Hospital General Univ. de Alicante
- Hospital de la Santa Creu i Sant Pau
- Hospital Universitari Dexeus - Grupo Quironsalud; Servicio de Oncologia Medica
- Hospital Univ Vall d'Hebron; Servicio de Oncologia
- C.A.U de Burgos- Hospital Universitario de Burgos; Servicio de Oncologia
- Hospital Universitari de Girona Dr Josep Trueta; Departamento de Oncologia Medica
- Hospital Lucus Augusti; Servicio de Oncologia
- MD Anderson Cancer Center
- Hospital Universitario Ramon y Cajal
- HM Sanchinarro - CIOCC
- Hospital Regional Universitario de Malaga - Hospital General; Servicio de Neurologia
- Instituto Valenciano Oncologia; Oncologia Medica
- Hospital Universitari i Politecnic La Fe de Valencia
- Buddhist Dalin Tzuchi General Hospital
- E-DA Hospital; Chest
- Chi Mei Medical Center Liou Ying Campus
- Taipei Veterans General Hospital
- National Taiwan Uni Hospital; Internal Medicine
- Tri-Service General Hospital
- MI Dnipropetrovsk City Multifield Clinical Hospital 4 of Dnipropetrovsk Regional Council
- Kyiv Railway Clinical Hospital #3 of Branch Health Center of PJSC Ukrainian Railway; Surgery Dept
- MICR Oncology Dispensary of Cherkasy Regional Council; Regional Center of Clinical Oncology
- Private Enterprise Private Manufacturing Company Acinus
- Regional Municipal Institution Sumy Regional Clinical Oncology Dispensary; Oncothoracic department
- MI Zaporizhzhia Regional Clinical Oncological Dispensary Zaporizhzhia SMU Ch of Oncology
- Bristol Haematology and Oncology Centre
- Velindre Hospital
- Gartnavel General Hospital; Beatson West of Scotland Cancer Centre
- Raigmore Hospital
- St George's Hospital
- Charing Cross Hospital
- Churchill Hospital
- Derriford Hospital; Plymouth Oncology Centre
- Queen's Hospital
- Royal Cornwall Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed
Arm B (Carboplatin or Cisplatin + Pemetrexed)
Participants received intravenous (IV) infusion of 1200 milligrams (mg) of atezolizumab on Day 1 every 3 weeks (q3w), IV infusion of 500 milligrams per meter square (mg/m^2) pemetrexed on Day 1 q3w, and as per investigator's choice either IV infusion of carboplatin on Day 1 q3w with a dose calculated using 'Calvert formula' to obtain area under concentration versus time (AUC) = 6 milligrams per milliliter per minute (mg/mL/min) or IV infusion of 75 mg/m^2 cisplatin q3w on Day 1 q3w, during induction dosing period of 4 or 6 cycles (Cycle length=21 days). Participants who experienced clinical benefit during the induction phase began maintenance therapy. Participants will receive IV infusion of 1200 mg of atezolizumab and 500 mg/m^2 of pemetrexed on Day 1 q3w until disease progression in the maintenance period.
Participants received IV infusion of 500 mg/m^2 pemetrexed on Day 1 q3w, and as per investigator's choice of either IV infusion of carboplatin on Day 1 q3w with a dose calculated using 'Calvert formula' to obtain AUC =6 mg/mL/min or IV infusion of 75 mg/m^2 cisplatin q3w on Day 1 q3w, during induction dosing period for 4 or 6 cycles (Cycle length=21 days). Participants who did not experience disease progression during the induction phase began maintenance therapy. Participants will receive IV infusion of 500 mg/m^2 of pemetrexed on Day 1 q3w until disease progression in the maintenance period.