{"entity":{"id":"paper-impower110-atezolizumab-pd-l1-nejm-2020","kind":"paper","name":"IMpower110: atezolizumab for first-line treatment of PD-L1-selected patients with non-small-cell lung cancer","aka":[],"tldr":"In patients whose lung cancer had the highest levels of the PD-L1 protein and no targetable mutation, an immunotherapy drug given alone added about seven months of life compared with chemotherapy.","summary":"Patients with metastatic non-squamous or squamous non-small-cell lung cancer who had not received chemotherapy and whose tumours expressed PD-L1 on at least 1% of tumour cells or at least 1% of tumour-infiltrating immune cells by the SP142 assay were randomly assigned to atezolizumab or platinum-based chemotherapy. Overall survival was tested hierarchically by PD-L1 expression among patients whose tumours were wild-type for EGFR and ALK. Of 572 patients enrolled, in the 205 with the highest PD-L1 expression and wild-type EGFR and ALK, median overall survival was 20.2 months with atezolizumab against 13.1 months with chemotherapy, hazard ratio 0.59. Grade 3 or 4 adverse events occurred in 30.1% with atezolizumab and 52.5% with chemotherapy. Survival also favoured atezolizumab in the subgroups with high blood-based tumour mutational burden.","asOf":"2026-09-25","links":[{"label":"Herbst et al., N Engl J Med 2020: IMpower110, first-line atezolizumab in PD-L1-selected non-small-cell lung cancer (SP142)","url":"https://doi.org/10.1056/NEJMoa1917346"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/32997907/"}],"tags":[],"related":["pd-l1-tc-score","pd-l1-ic-score","tmb-high"],"cancers":["nsclc"],"sections":[],"technologies":["checkpoint-inhibitor","histopathology-ihc"],"targets":["pdl1"],"drugs":["atezolizumab","ventana-pd-l1-sp142"],"companies":[],"institutions":[],"pathways":["pd1-checkpoint"],"terms":["ihc","tmb"],"trials":[],"people":["roy-herbst"],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2020,"doi":"10.1056/NEJMoa1917346","pmid":"32997907","authors":"Herbst RS, Giaccone G, de Marinis F, et al.","paperType":"rct","findings":["Median overall survival 20.2 against 13.1 months in the highest PD-L1 expression group, hazard ratio 0.59.","Selection used the SP142 assay with both tumour-cell and immune-cell scores.","Grade 3 or 4 adverse events 30.1% against 52.5% for chemotherapy.","Blood-based tumour mutational burden subgroups also favoured atezolizumab."],"whatItMeans":"It is the reason the SP142 assay and its two-compartment score remain in use despite being the least comparable of the PD-L1 assays: the atezolizumab threshold was defined on it and cannot simply be translated to another stain.","caveats":["The benefit was confined to the highest expression group; the hierarchical testing stopped there.","Open-label design.","The blood-based burden analysis was a subgroup exploration."],"changedPractice":true,"participants":572},"route":"/key-papers/paper-impower110-atezolizumab-pd-l1-nejm-2020/","neighbours":{"biomarker":[{"id":"pd-l1-ic-score","kind":"biomarker","name":"PD-L1 IC score (immune-cell score, SP142)","route":"/biomarkers/pd-l1-ic-score/"},{"id":"pd-l1-tc-score","kind":"biomarker","name":"PD-L1 TC score (tumour-cell score, SP263 and 28-8)","route":"/biomarkers/pd-l1-tc-score/"},{"id":"tmb-high","kind":"biomarker","name":"TMB-high (tumour mutational burden >= 10 mutations per megabase)","route":"/biomarkers/tmb-high/"}],"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"technology":[{"id":"histopathology-ihc","kind":"technology","name":"Histopathology & immunohistochemistry","route":"/technologies/histopathology-ihc/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"target":[{"id":"pdl1","kind":"target","name":"PD-L1","route":"/targets/pdl1/"}],"drug":[{"id":"atezolizumab","kind":"drug","name":"Atezolizumab","route":"/drugs/atezolizumab/"},{"id":"ventana-pd-l1-sp142","kind":"drug","name":"VENTANA PD-L1 (SP142) Assay","route":"/drugs/ventana-pd-l1-sp142/"}],"pathway":[{"id":"pd1-checkpoint","kind":"pathway","name":"PD-1 / PD-L1 immune checkpoint & T-cell activation","route":"/pathways/pd1-checkpoint/"}],"term":[{"id":"ihc","kind":"term","name":"Immunohistochemistry (IHC)","route":"/terms/ihc/"},{"id":"tmb","kind":"term","name":"Tumour mutational burden (TMB)","route":"/terms/tmb/"}],"person":[{"id":"roy-herbst","kind":"person","name":"Roy S. Herbst","route":"/people/roy-herbst/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}