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
Name: Bevacizumab
Name: Carboplatin
Name: Pemetrexed
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 yearsAllocation: N/A
Single 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 ---