Advanced / Metastatic · Phase III randomized double-blind; N=305 chemotherapy-naive metastatic nonsquamous NSCLC. Atezolizumab+bevacizumab+carboplatin+pemetrexed/paclitaxel vs placebo+bevacizumab+chemotherapy. Primary endpoint investigator PFS. · Median PFS 9.5 vs 7.1 months

IMpower151

Clinical question: Does adding atezolizumab to bevacizumab and chemotherapy improve PFS in metastatic nonsquamous NSCLC?

Median PFS 9.5 vs 7.1 months; HR 0.84 (95% CI 0.65–1.09; P=0.184). Median OS 20.7 vs 18.7 months; HR 0.93. ORR 48% vs 50%; primary endpoint negative. · Registry:

Design, population and treatment

Phase III randomized double-blind; N=305 chemotherapy-naive metastatic nonsquamous NSCLC. Atezolizumab+bevacizumab+carboplatin+pemetrexed/paclitaxel vs placebo+bevacizumab+chemotherapy. Primary endpoint investigator PFS.

Key efficacy outcome

9.5 · intervention

7.1

9.5 · comparator

No NNT: primary endpoint not statistically significant; no fixed-time survival difference.

Atezolizumab-specific AEs of special interest 68% vs 71%; grade 3–4 11% vs 7%.

Safety and absolute effect

Median PFS (months)

https://www.nature.com/articles/s41591-025-03658-y

Interpretation and limitations

Current-practice context · 14 November 2026: Primary publication/abstract and trial identifier checked. Guideline-level current-practice mapping was not established in this publication-led batch; no NCCN citation provenance is claimed. Where detailed QoL, follow-up or toxicity data were not present in the retrieved abstract, they are not inferred.

Primary source

Primary publication · DOI: 10.1038/s41591-025-03658-y