PhI­II lung can­cer da­ta sig­nal po­ten­tial ap­proval for As­traZeneca's Imfinzi

The da­ta on As­traZeneca’s Phase III Imfinzi tri­al are out, and it bodes well for the UK out­fit’s bid to get their sig­na­ture im­munother­a­py ap­proved for front­line small-cell lung can­cer (SCLC).

Pa­tients re­ceiv­ing the PD-L1 Imfinzi (along­side a stan­dard chemother­a­py reg­i­men) in As­traZeneca’s CASPI­AN study sur­vived for 13 months on av­er­age, com­pared with 10.3 months for pa­tients re­ceiv­ing the stan­dard of care. Those num­bers com­pare fa­vor­ably to the re­sults of the piv­otal study that pushed Roche’s PD-L1 Tecen­triq across the fin­ish line. Tecen­triq pa­tients had an OS of 12.3 months in that study, which was an­nounced six months be­fore the FDA ap­proved the drug for front­line SCLC. 

In­ves­ti­ga­tors al­so tout­ed their drug’s dura­bil­i­ty, with 33.9% of pa­tients still alive at 18 months fol­low­ing treat­ment with Imfinzi plus chemother­a­py vs 24.7% of pa­tients fol­low­ing the stan­dard of care.

The study may prove a ma­jor boon for As­traZeneca in the heady race to ex­pand their mar­kets for PD-1/L1 drugs — and in the drug­mak­er’s steady growth in the lung can­cer mar­ket. Last year, its stand­out Tagris­so was ap­proved for front­line treat­ment of EGFR-mu­tat­ed non-small cell lung can­cer. And Imfinzi has seized an im­por­tant niche in the lung can­cer mar­ket with its ap­proval for stage III non-small cell lung can­cer.

Al­though it ac­counts for less than 20% of lung can­cer cas­es, SCLC re­mains par­tic­u­lar­ly dif­fi­cult to treat.

PD-1 and PD-L1 drugs work by in­hibit­ing pro­teins can­cer cells use to block T cells from at­tack­ing them. This makes them a prime fo­cus for on­col­o­gy re­search, and six PD-1/L1 im­munother­a­pies, both for SCLC and a slew of oth­er can­cers, have al­ready been ap­proved by the FDA, with a host of tri­als un­der­way to ex­pand their use. 

Mer­ck has been the leader in PD-1/L1 thus far, with its sig­na­ture drug Keytru­da pro­ject­ed to be a glob­al top-10 block­buster by 2024. 

For As­traZeneca, the Phase III CASPI­AN re­sults come as wel­come news af­ter its com­bi­na­tion of Imfinzi and treme­li­mum­ab failed tri­als for head and neck can­cer, and for an­oth­er form of lung can­cer. The study was con­duct­ed on 537 pa­tients re­ceiv­ing first-line treat­ment for non-small cell lung can­cer in over 200 cen­ters, across 22 coun­tries and four con­ti­nents. 

José Basel­ga As­traZeneca

We are en­cour­aged to see more than a third of small cell lung can­cer pa­tients treat­ed with Imfinzi plus chemother­a­py alive at the 18-month land­mark, which is re­mark­able giv­en the ag­gres­sive na­ture of the dis­ease,” José Basel­ga, As­traZeneca’s ex­ec­u­tive vice pres­i­dent of on­col­o­gy R&D, said in a state­ment. 

Imfinzi, al­ready ap­proved for un­re­sect­ed stage III SCLC, is al­so be­ing test­ed with con­cur­rent chemother­a­py for lim­it­ed-stage SCLC in As­traZeneca’s Phase III ADRI­AT­IC tri­al. Roche an­nounced to­day it will con­duct a Phase I/II tri­al with KAHR med­ical to treat NSCLC pa­tients who are re­frac­to­ry, or re­sis­tant, to check­point in­hibitors. 

 

Cor­rec­tion: An ear­li­er ver­sion of this ar­ti­cle in­cor­rect­ly iden­ti­fied Mer­ck as Mer­ck KGaA. Ref­er­ences to Mer­ck KGaA have been re­moved. 

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