This project will recruit 40 EGFR-mutant metastatic non-small cell lung cancer patients who failed any EGFR tyrosine kinase inhibitors. All recruited patients will receive 1200mg Azetolizumab administered over 60 minutes (1st cycle) and 30 minutes (2nd cycle onwards) intravenously, as well as 7.5mg/kg bevacizumab administered over 90 minutes (1st cycle), 60 minutes (2nd cycle) and 30 minutes (3rd cycle onwards) for every 3 weeks, until radiographically documented disease progression, unacceptable toxicity as judged by investigators or patient withdrawal. The primary objective is to assess the progression-free survival of this treatment population, and to identify potential genomic and immunologic biomarkers for treatment response. Objective response rate (ORR) will be the primary efficacy endpoint.
Name: Atezolizumab
Description: Atezolizumab (trade name Tecentriq) is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1).Type: DrugArm 1
Name: Bevacizumab
Description: Bevacizumab is a recombinant humanized monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A).Type: DrugArm 1
Name: Carboplatin
Description: Carboplatin, sold under the trade name Paraplatin among others, is a chemotherapy medication used to treat a number of forms of cancer.Type: DrugArm 1
Name: Pemetrexed
Description: Pemetrexed (brand name Alimta) is a chemotherapy drug manufactured and marketed by Eli Lilly and Company. Its indications are the treatment of pleural mesothelioma and non-small cell lung cancer.Type: DrugArm 1
Description: The percentage of patients with radiologically complete or partial response as determined by the investigator according to RECIST version 1.1.
Measure: Objective response rate (ORR) Time: 3 yearsDescription: PFS is measured from the date of study enrollment to radiographically documented progression according to RECIST 1.1 or death from any cause (whichever occurs first). Participants alive and without disease progression or lost to follow-up will be censored at the date of their last radiographic assessment.
Measure: Progression-free Survival (PFS) Time: 3 yearsDescription: TTP is measured from the date of study enrollment to radiographically documented progression according to RECIST 1.1. This does not include death from any cause.
Measure: Time to progression (TTP) Time: 3 yearsSingle Group Assignment
There is one SNP
The use of neoadjuvant or adjuvant platinum-based chemotherapy more than 6 months before study enrollment is allowed - Previous exposure to VEGF inhibitor for anti-cancer treatment - Prior treatment with any other anti-programmed cell death protein-1 (anti-PD-1), or PD Ligand-1 (PD-L1) or PD Ligand-2 (PDL2) agent or an antibody targeting other immuno-regulatory receptors or mechanisms - Patients carries EGFR genotype T790M but have not received 3rd generation EGFR TKI Osimertinib - Currently participating or has participated in a study of an investigational agent or using an investigational device within 4 weeks of administration of atezolizumab - Expected to require any other form of antineoplastic therapy while on study - Patients with untreated symptomatic brain metastases. --- T790M ---