ABSTRACT Background The IMpower150 trial demonstrated the efficacy of atezolizumab, bevacizumab, carboplatin, and paclitaxel ( ABCP ) therapy in epidermal growth factor receptor ( EGFR )‐mutated non‐small cell lung cancer ( NSCLC ). However, its efficacy in patients with NSCLC harboring other genetic alterations in real‐world settings remains unclear. This study aimed to retrospectively evaluate the efficacy of ABCP therapy in patients with NSCLC harboring other genetic alterations. Methods We retrospectively analyzed 61 patients with advanced NSCLC (33 with EGFR mutations: EGFR group and 28 with other genetic alterations: other group) who received ABCP therapy between January 2019 and December 2023 at a single institution in Japan, and evaluated efficacy and toxicities. Results Most baseline characteristics were similar except treatment timing ( p < 0.001) in both groups. The median progression‐free survival ( PFS ) was 4.5 vs. 5.1 months ( p = 0.663), and the objective response rate ( ORR ) was 45.5% vs. 50.0% ( p = 0.77) between the EGFR and other groups. In multivariate analysis, PD ‐ L1 expression ≥ 50% was independently associated with longer PFS ( HR 0.23, p < 0.001). Grade ≥ 3 adverse events were manageable and occurred at similar rates (51.5% vs. 53.6%) between the EGFR and other groups, and discontinuation was low (9.8%). Subgroup analysis for patients with KRAS mutation ( n = 14) and anaplastic lymphoma kinase ( ALK ) fusion ( n = 6) showed trends consistent with the overall cohort. Conclusions ABCP therapy demonstrated efficacy and manageable toxicity in NSCLC patients in both groups. Notably, those with high PD ‐ L1 expression (≥ 50%) may derive greater PFS benefit. Further confirmation in larger prospective trials is warranted.
Tanaka et al. (Mon,) studied this question.