A Study of Atezolizumab in Combination With Carboplatin Plus (+) Paclitaxel With or Without Bevacizumab Compared With Carboplatin+Paclitaxel+Bevacizumab in Participants With Stage IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC)

Carcinoma, Non-Small-Cell Lung Clinical Trial

— IMpower150  

Official title:

A Phase III, Open-Label, Randomized Study of Atezolizumab (MPDL3280A, Anti-PD-L1 Antibody) in Combination With Carboplatin+Paclitaxel With or Without Bevacizumab Compared With Carboplatin + Paclitaxel + Bevacizumab in Chemotherapy-Naïve Patients With Stage IV Non-Squamous Non-Small Cell Lung Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02366143
• Other study ID #: GO29436
• Secondary ID: 2014-003207-30
• Status: Completed
• Phase: Phase 3
• Start date: March 31, 2015
• Est. completion date: December 7, 2020

Study information

• Verified date: August 2021
• Source: Hoffmann-La Roche
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This randomized, open-label study evaluated the safety and efficacy of atezolizumab (an engineered anti-programmed death-ligand 1 [PD-L1] antibody) in combination with carboplatin+paclitaxel with or without bevacizumab compared with treatment with carboplatin+paclitaxel+bevacizumab in chemotherapy-naïve participants with Stage IV non-squamous NSCLC. Participants were randomized in a 1:1:1 ratio to Arm A (Atezolizumab+Carboplatin+Paclitaxel), Arm B (Atezolizumab+Carboplatin+Paclitaxel+Bevacizumab), or Arm C (Carboplatin+Paclitaxel+Bevacizumab).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1202
• Est. completion date: December 7, 2020
• Est. primary completion date: September 13, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Eastern Cooperative Oncology Group performance status 0 or 1

• Histologically or cytologically confirmed, Stage IV non-squamous NSCLC

• Participants with no prior treatment for Stage IV non-squamous NSCLC

• Known PD-L1 status as determined by immunohistochemistry assay performed on previously obtained archival tumor tissue or tissue obtained from a biopsy at screening

• Measurable disease as defined by RECIST v1.1

• Adequate hematologic and end organ function

Exclusion Criteria:

Cancer-Specific Exclusions:

• Active or untreated central nervous system metastases

• Malignancies other than NSCLC within 5 years prior to randomization, with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome

General Medical Exclusions:

• Pregnant or lactating women

• History of autoimmune disease

• History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted

• Positive test for human immunodeficiency virus

• Active hepatitis B or hepatitis C

• Severe infection within 4 weeks prior to randomization

• Significant cardiovascular disease

• Illness or condition that interferes with the participant's capacity to understand, follow and/or comply with study procedures

Exclusion Criteria Related to Medications:

• Prior treatment with cluster of differentiation 137 agonists or immune checkpoint blockade therapies, anti-programmed death-1, and anti-PD-L1 therapeutic antibodies

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung

Intervention

Drug:
• Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody
Atezolizumab was administered as IV infusion at a dose of 1200 milligrams (mg) on Day 1 of each 21-day cycle until loss of clinical benefit.
• Bevacizumab
Bevacizumab was administered as IV infusion at a dose of 15 milligrams per kilogram (mg/kg) on Day 1 of each 21-day cycle until progressive disease, unacceptable toxicity, or death.
• Carboplatin
Carboplatin was administered at area under the concentration-time curve (AUC) 6 milligrams per milliliter per minute (mg/mL/min) on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first.
• Paclitaxel
Paclitaxel was administered as IV infusion at a dose of 200 milligrams per square meter (mg/m^2) on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first.

Locations

Country	Name	City	State
Argentina	Centro Medico Austral	Buenos Aires
Argentina	Fundación CENIT para la Investigación en Neurociencias	Buenos Aires
Argentina	Sanatorio Allende	Cordoba
Argentina	Centro Oncologico Riojano Integral (CORI)	La Rioja
Argentina	Hospital Provincial del Centenario	Rosario
Argentina	Fundacion Koriza	Santa Rosa
Argentina	Centro de Investigacion; Clinica - Clinica Viedma S.A.	Viedma
Australia	Royal Adelaide Hospital	Adelaide	South Australia
Australia	Chris O'Brien Lifehouse	Camperdown	New South Wales
Australia	Prince Charles Hospital; Department of Medical Oncology	Chermside	Queensland
Australia	Concord Repatriation General Hospital	Concord	New South Wales
Australia	Frankston Hospital	Frankston	Victoria
Australia	Austin Health	Heidelberg	Victoria
Australia	Royal Hobart Hospital	Hobart	Tasmania
Australia	Adelaide Cancer Centre	Kurralta Park	South Australia
Australia	Launceston General Hospital	Launceston	Tasmania
Australia	Cabrini Hospital Malvern	Malvern	Victoria
Australia	Sir Charles Gairdner Hospital	Nedlands	Western Australia
Australia	The Alfred Hospital	Prahan	Victoria
Australia	Sunshine Hospital	St Albans	Victoria
Australia	Nepean Cancer Care Centre	Sydney	New South Wales
Australia	Townsville Hospital	Townsville	Queensland
Australia	Princess Alexandra Hospital	Woolloongabba	Queensland
Austria	Paracelsus Medizinische Privatuniversität	Salzburg
Austria	Klinikum Wels-Grieskirchen	Wels
Belgium	CHU de Liège	Liège
Belgium	Clinique Ste-Elisabeth	Namur
Brazil	Hospital de Cancer de Barretos	Barretos	SP
Brazil	IPCEM; Instituto de Pesquisa de Estudos Multicêntricos	Caxias do Sul	RS
Brazil	Instituto Do Cancer Delondrina_X; Unidade De Pesquisa Clinica	Londrina	PR
Brazil	Liga Norte Riograndense Contra O Câncer	Natal	RN
Brazil	Hospital Mae de Deus	Porto Alegre	RS
Brazil	Instituto Ribeirãopretano de Combate Ao Câncer; Centro Especializado De Oncologia	Ribeirão Preto	SP
Brazil	Hospital de Base de Sao Jose do Rio Preto	Sao Jose do Rio Preto	SP
Brazil	Hospital A. C. Camargo; Oncologia	Sao Paulo	SP
Brazil	CETUS Hospital Dia Oncologia	Uberaba	MG
Bulgaria	Multiprofile Hospital for Active Treatment Central Onco Hospital OOD	Plovdiv
Bulgaria	MHAT Serdika, EOOD	Sofia
Canada	Lakeridge Health Center	Oshawa	Ontario
Chile	Clinica Santa Maria	Santiago
Chile	Health & Care SPA	Santiago
Chile	Sociedad de Investigaciones Medicas Ltda (SIM)	Temuco
France	Institut Bergonié Centre Régional de Lutte Contre Le Cancer de Bordeaux Et Sud Ouest	Bordeaux
France	CHU de Grenoble	Grenoble
France	Centre Jean Bernard Clinique Victor Hugo	Le Mans
France	Hopital Nord AP-HM	Marseille
France	Hôpital Saint Joseph	Marseille
France	Hôpital Européen Georges Pompidou	Paris
France	CHU de Bordeaux	Pessac
France	Service de Pneumologie Centre Hospitalier Régional La Réunion Site Felix Guyon	Saint Denis Cedex
France	CH de Saint Quentin	Saint Quentin
France	Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer	Toulon
France	Hôpital d'Instruction des Armées de Sainte Anne; Service de Pneumologie	Toulon
France	Hôpital Larrey;Université Paul Sabatier	Toulouse
Germany	Zentralklinikum Augsburg	Augsburg
Germany	Helios Klinikum Emil von Behring GmbH	Berlin
Germany	Ev.Krankenhaus Bielefeld gGmbH; Klinik für Innere Medizin und Geriatrie	Bielefeld
Germany	Augusta Kranken-Anstalt gGmbH	Bochum
Germany	Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden	Dresden
Germany	St. Elisabethen Krankenhaus	Frankfurt am Main
Germany	LungenClinic Großhansdorf GmbH	Großhansdorf
Germany	Krankenhaus Martha-Maria; Halle-Dolau gGmbH	Halle
Germany	Asklepios Klinik Harburg	Hamburg
Germany	Lungenklinik Hemer	Hemer
Germany	Universität Des Saarlandes; Klinik für Innere Medizin V	Homburg
Germany	Kliniken der Stadt Koln gGmbH; Lungenklinik Onkologische Ambulanz	Koln
Germany	Klinik Loewenstein gGmbH; Onk & Pal	Loewenstein
Germany	Klinikum Bogenhausen	München
Germany	Klinikum der Universität Regensburg	Regensburg
Germany	Krankenhaus Barmherzige Bruder Regensburg	Regensburg
Germany	Stiftung Mathias-Spital Rheine	Rheine
Italy	Policlinico Vittorio Emanuele	Catania	Sicilia
Italy	ASL 3 Genovese; DSM	Genova	Liguria
Italy	Istituto Nazionale per la Ricerca sul Cancro di Genova	Genova	Liguria
Italy	Ospedale Versilia	Lido Di Camaiore	Toscana
Italy	Ospedale Civile - Livorno	Livorno	Toscana
Italy	AORN A Cardarelli	Napoli	Campania
Italy	A.O.U. Maggiore della Carità	Novara	Piemonte
Italy	Azienda Ospedaliera San Camillo Forlanini	Roma	Lazio
Italy	Policlinico Universitario Campus Biomedico; Uoc Oncologia Medica	Roma	Lazio
Italy	Università Cattolica Del S Cuore	Roma	Lazio
Italy	Azienda Unita Sanitaria Locale N1 Sassari; Unita Operativa Di Oncologia Medica	Sassari	Sardegna
Japan	National Hospital Organization Shikoku Cancer Center	Ehime
Japan	Kurume University Hospital	Fukuoka
Japan	National Hospital Organization Kyushu Medical Center	Fukuoka
Japan	NHO Kyushu Cancer Center	Fukuoka
Japan	Kanagawa Cardiovascular and Respiratory Center	Kanagawa
Japan	Kitasato University Hospital	Kanagawa
Japan	Kyoto University Hospital	Kyoto
Japan	Miyagi Cancer Center	Miyagi
Japan	Niigata Cancer Center Hospital	Niigata
Japan	National Hospital Organization Osaka Toneyama Medical Center	Osaka
Japan	Osaka City University Hospital	Osaka
Japan	Center Hospital of the National Center for Global Health and Medicine	Tokyo
Japan	Kyorin University Hospital	Tokyo
Japan	Toranomon Hospital	Tokyo
Japan	Wakayama Medical University Hospital	Wakayama
Latvia	Pauls Stradins Clinical University Hospital	Riga
Latvia	Riga East Clinical University Hospital Latvian Oncology Centre	Riga
Lithuania	National Cancer Institute	Vilnius
Mexico	Centro Universitario Contra El Cancer	Monterrey
Mexico	Cancerologia de Queretaro	Queretaro
Mexico	Centro Hemato Oncologico Privado; Oncologia	Toluca
Netherlands	Jeroen Bosch Ziekenhuis	'S Hertogenbosch
Netherlands	Amsterdam UMC Location VUMC	Amsterdam
Netherlands	Amphia Ziekenhuis; Afdeling Longziekten	Breda
Netherlands	Ziekenhuis Gelderse Vallei	EDE
Netherlands	Tergooiziekenhuizen	Hilversum
Netherlands	Spaarne Gasthuis; Spaarne Ziekenhuis	Hoofddorp
Netherlands	Maastricht University Medical Center	Maastricht
Netherlands	St. Antonius Ziekenhuis; R&D Long	Nieuwegein
Netherlands	Erasmus MC; Afdeling Longziekten	Rotterdam
Netherlands	Maasstad ziekenhuis	Rotterdam
Netherlands	Universitair Medisch Centrum Utrecht	Utrecht
Netherlands	Gelre Ziekenhuizen, Zutphen	Zutphen
Peru	Centro Especializado de Enfermedades Neoplásicas	Arequipa
Peru	Centro Medico Monte Carmelo	Arequipa
Peru	Instituto Nacional de Enfermedades Neoplasicas	Lima
Portugal	Centro Hospitalar E Universitário de Coimbra EPE	Coimbra
Portugal	Hospital Pulido Valente; Servico de Pneumologia	Lisboa
Portugal	Instituto Portugues Oncologia de Lisboa Francisco Gentil EPE	Lisboa
Portugal	Centro Hospitalar do Porto - Hospital de Santo António	Porto
Portugal	Hospital de Sao Joao; Servico de Pneumologia	Porto
Portugal	Instituto Portugues de Oncologia Do Porto Francisco Gentil Epe	Porto
Russian Federation	Moscow City Oncology Hospital #62	Moscovskaya Oblast	Moskovskaja Oblast
Russian Federation	Russian Oncology Research Center n.a. N.N. Blokhin	Moscow
Russian Federation	Clinical Oncology Dispensary	Omsk
Russian Federation	Evromedservis LCC	Pushkin
Russian Federation	City Clinical Oncology Dispensary	Saint-Petersburg
Singapore	National Cancer Centre; Medical Oncology	Singapore
Slovakia	Narodny onkologicky ustav	Bratislava
Slovakia	Univerzitna nemocnica Bratislava	Bratislava
Slovakia	POKO Poprad s.r.o.	Poprad
Spain	Hospital Clinic de Barcelona	Barcelona
Spain	Hospital del Mar	Barcelona
Spain	Hospital Univ Vall d'Hebron; Servicio de Oncologia	Barcelona
Spain	Hospital Universitario Reina Sofia	Cordoba
Spain	Instituto Catalan de Oncologia de Hospitalet (ICO); Servicio de Farmacia	L'Hospitalet de Llobregat	Barcelona
Spain	Hospital Universitario Insular de Gran Canaria	Las Palmas de Gran Canaria	LAS Palmas
Spain	Hospital Lucus Augusti; Servicio de Oncologia	Lugo
Spain	Hospital Clinico San Carlos; Servicio de Oncologia	Madrid
Spain	Hospital General Universitario Gregorio Marañon; Servicio de Oncologia	Madrid
Spain	Hospital Ramon y Cajal; Servicio de Oncologia	Madrid
Spain	Hospital Universitario 12 de Octubre	Madrid
Spain	Hospital Universitario Fundación Jimenez Díaz	Madrid
Spain	Hospital Universitario HM Sanchinarro-CIOCC	Madrid
Spain	Hospital Universitario La Paz	Madrid
Spain	Complejo Hospitalario U. de Ourense	Ourense	Orense
Spain	Hospital Universitario Son Espases	Palma De Mallorca	Islas Baleares
Spain	Corporacio Sanitaria Parc Tauli; Servicio de Oncologia	Sabadell	Barcelona
Spain	Hospital Universitario Marques de Valdecilla	Santander	Cantabria
Spain	Hospital Clinico Universitario de Valencia	Valencia
Spain	Hospital Lluis Alcanyis De Xativa	Xativa	Valencia
Switzerland	Kantonsspital Baselland	Bruderholz
Switzerland	Luzerner Kantonsspital Sursee	Luzern
Switzerland	Kantonsspital St. Gallen; Onkologie/Hämatologie	St. Gallen
Taiwan	Changhua Christian Hospital; Hematology-Oncology	Changhua
Taiwan	Kaohsiung Medical University Hospital; Department of Urology	Kaohsiung City
Taiwan	Chi Mei Medical Center Liou Ying Campus	Liuying Township
Taiwan	Chang Gung Memorial Hospital Chiayi	Putzu
Taiwan	National Cheng Kung Univ Hosp	Tainan
Taiwan	Cheng Hsin General Hospital	Taipei
Taiwan	Tri-Service General Hospital	Taipei
Taiwan	National Taiwan Uni Hospital	Taipei City
Taiwan	Chang Gung Medical Foundation Linkou Branch	Taoyuan City
Taiwan	Taichung Veterans General Hospital	Xitun Dist.
Ukraine	ME Bukovinian Clinical Oncology Center	Chernivtsi	Chernihiv Governorate
Ukraine	Municipal Institution City Clinical Hospital #4 of Dnipro City Council - PPDS; Dept of Chemotherapy	Dnipropetrovsk	Katerynoslav Governorate
Ukraine	Municipal Institution SubCarpathian Clinical Oncological Centre; Surgical department#2	Ivano-Frankivsk	KIEV Governorate
Ukraine	Communal Non profit Enterprise Regional Center of Oncology; Oncosurgical dept of thoracic organs	Kharkiv	Kharkiv Governorate
Ukraine	SI Institute of Medical Radiology n.a. S.P. Hryhoriev of NAMS of Ukraine	Kharkiv
Ukraine	ME Kryviy Rih Oncology Dispensary of Dnipropetrovs'k Regional Council; Chemotherapy Department	Kryvyi Rih
Ukraine	Kyiv City Clinical Oncological Center	Kyiv
Ukraine	Poltava Regional Clinical Oncology Dispensary of Poltava Regional Council; Thoracic department	Poltava
Ukraine	Regional Municipal Institution Sumy Regional Clinical Oncology Dispensary	Sumy
Ukraine	MNPE Transcarpathian Antitumor Center of the Transcarpathian Regional Council; Chemotherapy Dept	Uzhhorod	Kherson Governorate
Ukraine	Uzhgorod Central City Clinical Hospital	Uzhhorod	Katerynoslav Governorate
Ukraine	Communal Nonprofit Enterprise Podilsky Regional Center Of Oncology OfTheVinnytsia Regional Council	Vinnytsia	KIEV Governorate
Ukraine	MNPE Zaporizhzhia Regional Antitumor Center ZRC	Zaporizhzhia	Katerynoslav Governorate
United States	St. Joseph Mercy Health System	Ann Arbor	Michigan
United States	Piedmont Cancer Institute, PC	Atlanta	Georgia
United States	MultiCare Regional Cancer Center - Auburn	Auburn	Washington
United States	Mercy Medical Center	Baltimore	Maryland
United States	Southern CA Permanente Med Grp	Bellflower	California
United States	Bend Memorial Clinic	Bend	Oregon
United States	St. Charles Medical Center Bend; Cancer Care Of The Cascades	Bend	Oregon
United States	Summit Medical Group	Berkeley Heights	New Jersey
United States	Regional Cancer Care Associates	Bethesda	Maryland
United States	St. Luke's Cancer Care Associates	Bethlehem	Pennsylvania
United States	Hematology-Oncology; Associates of the Quad Cities	Bettendorf	Iowa
United States	Billings Clinic	Billings	Montana
United States	Montefiore Medical Center	Bronx	New York
United States	Maimonides Medical Center	Brooklyn	New York
United States	Ironwood Cancer & Research Centers	Chandler	Arizona
United States	Rush University Medical Center	Chicago	Illinois
United States	Univ of Chicago	Chicago	Illinois
United States	University of Cincinnati	Cincinnati	Ohio
United States	Maryland Oncology Hematology, P.A.	Columbia	Maryland
United States	Danbury Hospital	Danbury	Connecticut
United States	Rocky Mountain Cancer Center	Denver	Colorado
United States	St. Luke's Regional Cancer Center	Duluth	Minnesota
United States	Providence Regional Cancer Partnership	Everett	Washington
United States	Virginia Cancer Specialists, PC	Fairfax	Virginia
United States	Arizona Oncology Associates	Flagstaff	Arizona
United States	Holy Cross Hospital Inc	Fort Lauderdale	Florida
United States	West Clinic	Germantown	Tennessee
United States	Marin Cancer Care Inc	Greenbrae	California
United States	Ingalls Memorial Hospital	Harvey	Illinois
United States	Comprehensive Cancer Centers of Nevada	Henderson	Nevada
United States	Houston Methodist Cancer Center	Houston	Texas
United States	Cancer Specialists of North Florida - Baptist South	Jacksonville	Florida
United States	St. Luke's Cancer Institute	Kansas City	Missouri
United States	Tennessee Cancer Specialists	Knoxville	Tennessee
United States	Scripps Health	La Jolla	California
United States	Kaiser Permanente	Lonetree	Colorado
United States	Longview Cancer Center	Longview	Texas
United States	Norton Cancer Institute	Louisville	Kentucky
United States	Mount Sinai Medical Center	Miami Beach	Florida
United States	Montana Cancer Specialists	Missoula	Montana
United States	West Virginia University; Mary Babb Randolph Can Ctr	Morgantown	West Virginia
United States	Yale Cancer Center	New Haven	Connecticut
United States	Virginia Oncology Associates	Norfolk	Virginia
United States	Chao Family Comprehensive Cancer Center UCI	Orange	California
United States	Valley Hospital; Oncology Research	Paramus	New Jersey
United States	Oncology Specialists, S.C.	Park Ridge	Illinois
United States	First Health of the Carolinas	Pinehurst	North Carolina
United States	Allegheny Cancer Center	Pittsburgh	Pennsylvania
United States	Univ of Pittsburgh Medical Ctr	Pittsburgh	Pennsylvania
United States	Hematology Oncology Associates of the Treasure Coast	Port Saint Lucie	Florida
United States	Virginia Cancer Institute	Richmond	Virginia
United States	Blue Ridge Cancer Care	Roanoke	Virginia
United States	Missouri Baptist Medical Center	Saint Louis	Missouri
United States	Park Nicolett - Frauenshuh Cancer Center	Saint Louis Park	Minnesota
United States	University of Texas Health Science Center at San Antonio	San Antonio	Texas
United States	New England Cancer Specialists	Scarborough	Maine
United States	Virginia Mason Medical Center	Seattle	Washington
United States	Regional Cancer Care Associates LLC	Sewell	New Jersey
United States	Medical Oncology Associates	Spokane	Washington
United States	Willamette Valley Cancer Insitute and Research Center	Springfield	Oregon
United States	Mercy St Anne Hospital	Toledo	Ohio

Sponsors (1)

Lead Sponsor	Collaborator
Hoffmann-La Roche

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Austria,  Belgium,  Brazil,  Bulgaria,  Canada,  Chile,  France,  Germany,  Italy,  Japan,  Latvia,  Lithuania,  Mexico,  Netherlands,  Peru,  Portugal,  Russian Federation,  Singapore,  Slovakia,  Spain,  Switzerland,  Taiwan,  Ukraine, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Progression Free Survival (PFS), as Determined by the Investigator in Arm B Versus Arm C in the Teff-high WT Population and ITT-WT Population	Progression Free Survival (PFS), as Determined by the Investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Arm B versus Arm C in the T-effector (Teff)-high wild type (WT) population and the intent-to-treat (ITT)-WT population.	Baseline until disease progression or death, whichever occurs first until data cut-off on 15 September 2017 (up to approximately 29 months)
Primary	Overall Survival (OS) in Arm B Versus Arm C in ITT-WT Population	Overall Survival (OS) in Arm B Versus Arm C in ITT-WT Population	Baseline until death until data cut-off on 22 January 2018 (up to approximately 34 months)
Primary	Overall Survival (OS) in Arm A Versus Arm C in ITT-WT Population	Overall Survival (OS) in Arm A Versus Arm C in ITT-WT Population	Baseline until death (up approximately 53 months)
Secondary	PFS, as Determined by the Independent Review Facility (IRF) in Arm B Versus Arm C in Teff-High-WT Population and ITT-WT Population	PFS, as determined by the independent review facility (IRF) Using RECIST v1.1 in Arm B versus Arm C in the T-effector (Teff)-high wild type (WT) population and the intent-to-treat (ITT)-WT population.	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	PFS, as Determined by the Investigator in Arm B Versus Arm C in Teff High Population and ITT Population	PFS, as determined by the investigator according to RECIST v1.1, in Arm B versus C in the Teff high population and ITT population.	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	PFS, as Determined by the Investigator in Arm A Versus Arm B in Teff High-WT Population and ITT-WT Population	PFS, as determined by the investigator according to RECIST v1.1, in Arm A versus B in the Teff high-WT population and ITT-WT population.	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	PFS, as Determined by the Investigator in Arm B Versus Arm C by PD-L1 Subgroup	PFS as Determined by the Investigator according to RECIST v1.1, in Arm B Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	OS in Arm B Versus Arm C by PD-L1 Subgroup	OS in Arm B Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)	Baseline until death (up to approximately 34 months)
Secondary	OS in Arm A Versus Arm C by PD-L1 Subgroup	OS in Arm A Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)	Baseline until death (up approximately 53 months)
Secondary	OS in Arm B Versus Arm C in Teff High-WT Population, Teff High Population, and ITT Population		Baseline until death (up to approximately 34 months)
Secondary	OS in Arm A Versus Arm C in Teff High-WT Population, Teff High Population, and ITT Population		Baseline until death (up approximately 53 months)
Secondary	OS in Arm A Versus Arm B in Teff High-WT Population and ITT-WT Population		Baseline until death (up approximately 53 months)
Secondary	Duration of Response (DOR), as Determined By Investigator in Arm B Versus Arm C	DOR, as determined by investigator according to RECIST v1.1 in Arm B versus Arm C in the Teff high-WT population and the ITT-WT population.	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	Percentage of Participants With an Objective Response (OR) (Complete Response [CR] or Partial Response [PR]) as Determined by the Investigator in the Teff-High-WT Population and ITT-WT Population	Percentage of Participants With an Objective Response (OR) (Complete Response [CR] or Partial Response [PR]) as Determined by the Investigator using RECIST v1.1 in the Teff-High-WT population and ITT-WT population.	Baseline until disease progression or death, whichever occurs first (up to approximately 29 months)
Secondary	OS Rates at Years 1 and 2 in Arm B Versus Arm C	OS at 1- and 2-year landmark timepoints in Teff-high WT population and ITT-WT population.	Baseline to 2 years or death, whichever occurs first.
Secondary	OS Rates at Years 1 and 2 in Arm A Versus Arm C	OS at 1- and 2-year landmark timepoints in Teff-high WT population and ITT-WT population.	Baseline to 2 years or death, whichever occurs first.
Secondary	Time to Deterioration (TTD) in Patient-Reported Lung Cancer Symptoms Determined by European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire-Core 30 (QLQ-C30) Score	EORTC QLQ-C30 is a validated & reliable self-report measure (Aaronson et al.1993;Fitzsimmons et al.1999) that consists of 30 questions that assess 5 aspects of patient functioning (physical,emotional,role, cognitive,and social), 3 symptom scales (fatigue,nausea & vomiting, pain),global health/quality of life,and six single items (dyspnea,insomnia, appetite loss,constipation,diarrhea, and financial difficulties). EORTC QLQ-C30 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life);however a high score for a symptom scale or item represents a high level of symptomatology or problems. A =10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al.1998).	Baseline up to approximately 29 months
Secondary	TTD in Patient-Reported Lung Cancer Symptoms as Determined by EORTC Quality-of-Life Questionnaire-Core Lung Cancer Module 13 (QLQ-LC13) Score	QLQ-LC13 Quality-of-Life Questionnaire Lung Cancer Module incorporates one multiple-item scale to assess dyspnea and a series of single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. The EORTC QLQ-LC13 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life); however, a high score for a symptom scale or item represents a high level of symptomatology or problems. A =10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al. 1998).	Baseline up to approximately 29 months
Secondary	Change From Baseline in Patient-Reported Lung Cancer Symptoms Score Using the Symptoms in Lung Cancer (SILC) Scale	The SILC (Symptoms in Lung Cancer) scale was used to assess patient-reported severity of lung cancer symptoms (chest pain, dyspnea, and cough). The SILC scale is a 9-item content validated self-report measure of lung cancer symptoms. It measures severity of cough, dyspnea, and chest pain with a symptom severity score. The SILC questionnaire comprises three individual symptoms (dyspnea, cough, chest pain) and are scored at the individual symptom level, thus have a dyspnea score, chest pain score, and cough score. Each individual symptom score is calculated as the average of responses for the symptom items [e.g. Chest Pain Score=mean (item 1; item 2)]. An increase in score is suggestive of a worsening in symptomology (i.e. frequency or severity). A score change of =0.3 points for the dyspnea and cough symptom scores is considered to be clinically significant; whereas a score change of =0.5 points for the chest pain score is considered to be clinically significant.	Baseline up to approximately 29 months
Secondary	Percentage of Participants With Adverse Events	Percentage of participants with at least one adverse event.	Baseline up to data cutoff date 7 December 2020 (up to approximately 68 months)
Secondary	Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Atezolizumab		Baseline up to approximately 29 months
Secondary	Maximum Observed Serum Concentration (Cmax) of Atezolizumab in Arm A and Arm B	The predose samples will be collected on the same day of treatment administration. The infusion duration of atezolizumab will be of 30-60 minutes.	Day 1 of Cycle 1 and 3 (Cycle length=21 days)
Secondary	Minimum Observed Serum Concentration (Cmin) of Atezolizumab Prior to Infusion in Arm A and Arm B		Day 21 of Cycles 1, 2 3, and 7 (Cycle length=21 days)
Secondary	Plasma Concentrations for Carboplatin in Arm A, Arm B, and Arm C		Predose (same day of treatment administration), 5-10 minutes before end of carboplatin infusion, 1 h after carboplatin infusion (infusion duration=15 to 30 minutes) on D1 of Cy1,3 (Cycle length=21 days)
Secondary	Plasma Concentrations for Paclitaxel in Arm A, Arm B, and Arm C		Predose (same day of treatment administration), 5-10 minutes before end of paclitaxel infusion, 1 h after paclitaxel infusion (infusion duration=3 h) on D1 of Cy1,3 (Cycle length=21 days)
Secondary	Cmax of Bevacizumab in Arm B and Arm C		Cycle 1 Day 1 and Cycle 3 Day 1 (Cycle length=21 days)
Secondary	Cmin of Bevacizumab in Arm B and Arm C		Cycle 1 Day 1 and Cycle 2 Day 21 (Cycle length=21 days)