REACT: Real-world survival outcomes with atezolizumab, bevacizumab, and chemotherapy for treatment of advanced non-squamous NSCLC

Introduction . Atezolizumab, bevacizumab, and chemotherapy (ABCP) is a standard of care for advanced non-squamous NSCLC, including post-TKI patients with EGFR/ALK mutations. Real-world data on ABCP efficacy in Russia are limited. Aim . To evaluate OS and PFS in real-world NSCLC patients who received ≥4 cycles of first-line ABCP followed by atezolizumab-bevacizumab (AB) maintenance. Materials and methods . REACT is an observational, retrospective, multicenter study of adult patients with advanced NSCLC (diagnosed 2021–2023) who received ≥4 ABCP cycles and started AB maintenance. Key endpoints included ORR, PFS, and OS. Results . Data from 108 patients were included: 78 patients (72.2%) received ABCP in first line (wild type) and 30 (27.8%) were post-TKI (EGFR/ALK+). Median age 57.6 years; 63.9% male. Baseline metastases: CNS (17.6%), liver (8.3%), bone (33.3%). ORR was 56.5% (59.0% first line); DCR 98.2%. Median PFS was 14.7 months (95% CI 12.4–23.9) in first line group and 9.3 months (95% CI 7.4–14.6) in post-TKI group. Median OS was 34.4 months (95% CI 21.8–NR) in first line group and 24.2 months (95% CI 21.8–NR) post-TKI. 2-year OS rates were 52.7% and 54.4%, respectively. High tumor burden (≥3 sites), large sum of longest diameters, and bone metastases were negative prognostic factors. Age, sex, smoking, and PD-L1 status had no significant impact. Conclusion . In this cohort, the ABCP regimen was highly effective. Results align with IMpower150 trial for post-TKI patients and demonstrate prolonged survival in the first-line setting.