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IMspire150 tested adding the immunotherapy drug atezolizumab to the two targeted pills used for BRAF-mutant melanoma; the triple combination kept the cancer from growing for longer as judged by the treating doctors, which earned it approval, but it did not help people live longer.
IMspire150 was a double-blind placebo-controlled phase 3 trial in previously untreated BRAF V600 mutation-positive unresectable or metastatic melanoma. After a 28-day run-in of vemurafenib and cobimetinib, patients continued the two targeted drugs with atezolizumab or placebo.
Investigator-assessed progression-free survival, the primary endpoint, was significantly longer with the triplet, which led to approval of atezolizumab with vemurafenib and cobimetinib in the United States in July 2020. Independent review did not confirm a significant difference, and the final overall survival analysis found no significant benefit. The trial, alongside COMBI-i, showed that layering a checkpoint inhibitor onto BRAF and MEK inhibition adds toxicity for a modest gain, and sequencing trials such as DREAMseq favour starting with immunotherapy.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
514 enrolled.
Median follow-up 18.9 months
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival (investigator-assessed)primary | Atezolizumab + vemurafenib + cobimetinib | 256 | 15.1 months | 0.78 (0.63 to 0.97) | 0.025 | link |
| Placebo + vemurafenib + cobimetinib | 258 | 10.6 months | ||||
| Stopped all treatment for adverse events | Atezolizumab + vemurafenib + cobimetinib | 256 | 13% | - | - | link |
| Placebo + vemurafenib + cobimetinib | 258 | 16% |
A second publication from the IMspire150 trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
This is the paper Europe PMC returns for registry id NCT02908672 with the most citations, so it is the natural first reading for anyone following the IMspire150 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
Shares Melanoma, Immune checkpoint inhibitors and the tag subtype-trials.
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Shares Roche / Genentech and the tag subtype-trials.
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Shares Immune checkpoint inhibitors and the tag subtype-trials.
Shares Immune checkpoint inhibitors and the tag subtype-trials.