# IMpower150

Source: https://onco.cc/trials/impower150/  
OnCo record `impower150` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Added an anti-VEGF antibody to chemotherapy and immunotherapy, and is the one first-line regimen with evidence in people whose cancer is driven by an EGFR or ALK change.

## Summary

IMpower150 had three arms: atezolizumab with carboplatin and paclitaxel, bevacizumab with carboplatin and paclitaxel, and atezolizumab with bevacizumab, carboplatin and paclitaxel, each for four or six cycles followed by maintenance. The comparison that mattered was the four-drug arm against the bevacizumab arm, tested first, in the EGFR and ALK wild-type population, where 356 and 336 patients were assigned.

Median progression-free survival was 8.3 months with the four-drug regimen against 6.8 months (hazard ratio for progression or death 0.62, 95 percent confidence interval 0.52 to 0.74), and overall survival was also significantly improved, regardless of PD-L1 expression or effector T-cell signature.

IMpower150 is quoted most often for something outside its primary analysis: its exploratory subgroup of patients with EGFR or ALK alterations who had progressed on targeted therapy did appear to benefit, which is why the four-drug regimen is still considered there when nothing else applies, and why the argument persists, since the subgroup is small and the finding exploratory. The FDA approved the regimen in 2018. In England NICE TA584 (5 June 2019) recommends atezolizumab in combination for metastatic non-squamous disease.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-25
- Registry id: NCT02366143
- Phase: 3
- Setting: Untreated metastatic non-squamous non-small-cell lung cancer: atezolizumab with carboplatin and paclitaxel, bevacizumab with carboplatin and paclitaxel, or atezolizumab with all three, every three weeks for four or six cycles then maintenance, with co-primary progression-free survival endpoints in the wild-type and effector T-cell-high populations and overall survival in the wild-type population
- Sponsor: Roche
- Enrolled: 1202
- Result: Median progression-free survival 8.3 against 6.8 months (hazard ratio 0.62) and significantly longer overall survival for atezolizumab with bevacizumab and chemotherapy over bevacizumab and chemotherapy.
- Outcomes: Progression-free survival (EGFR and ALK wild-type): Atezolizumab, bevacizumab, carboplatin and paclitaxel 8.3 months vs Bevacizumab, carboplatin and paclitaxel 6.8 months, HR 0.62

## Sources

- ClinicalTrials.gov NCT02366143: https://clinicaltrials.gov/study/NCT02366143
- IMpower150 (New England Journal of Medicine 2018): https://doi.org/10.1056/NEJMoa1716948
- NICE TA584: atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer: https://www.nice.org.uk/guidance/ta584

## Connected records

- cancers: [Adenocarcinoma of the lung](https://onco.cc/cancers/lung-adenocarcinoma/), [EGFR-mutated non-small-cell lung cancer](https://onco.cc/cancers/egfr-mutant-nsclc/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [Platinum agents](https://onco.cc/technologies/platinum/)
- targets: [PD-L1](https://onco.cc/targets/pdl1/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- drugs: [Atezolizumab](https://onco.cc/drugs/atezolizumab/), [Bevacizumab](https://onco.cc/drugs/bevacizumab/), [Carboplatin](https://onco.cc/drugs/carboplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- companies: [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- terms: [Drug resistance (primary and acquired)](https://onco.cc/terms/resistance/), [Immune checkpoint](https://onco.cc/terms/immune-checkpoint/)
- trials: [KEYNOTE-024 & KEYNOTE-189](https://onco.cc/trials/keynote-024-189/)

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