Roche boasts of stalling lung cancer with Tecentriq/chemo combo — but rival Merck stays out front

CHICAGO — Roche arrived at ASCO boasting a significant advance for treating frontline cases of advanced squamous non-small cell lung cancer with a combination of Tecentriq and chemo. But the advantage it offers may appear relatively marginal for patients and was quickly eclipsed by more extensive positive data from a dominant Merck.

We already learned the top-line results earlier from the pharma giant, which continues to have high hopes for the PD-L1 checkpoint inhibitor, even as it’s in danger of losing its third-place position behind Merck and Bristol-Myers Squibb to a surging AstraZeneca.

Researchers came to Chicago with some specifics on the data, notably highlighting a doubling of progression-free survival among large groups of patients on the combo compared to chemo alone. 

After 12 months of treatment, cancer had not worsened in 24.7% patients getting the Tecentriq/chemo combo compared to 12% for chemo alone. And that’s the first Phase III advantage that’s appeared for this group of patients in the all-important lung cancer field.  Median PFS was 6.3 months for the Roche checkpoint vs. 5.6 months for the control — not the kind of gap that is likely to stir excitement.

That likely creates big trouble for Roche. Merck released its own readout on positive survival data on Sunday from Keynote-407. Merck is already the PD-1 leader in treating frontline lung cancer, and Roche hasn’t changed those dynamics at ASCO.

Daniel O’Day

What’s at stake?

Jefferies has been expecting to see $1.1 billion of peak sales for Tecentriq in this frontline squamous setting and previously highlighted that a positive result from the trial could see 1%-3% upside to EPS and valuation.

There was no overall survival benefit visible at this interim point of the Roche study as researchers reported median OS of 14 months for atezolizumab plus chemotherapy vs. 13.9 months for chemotherapy alone at this point. Researchers say they will have a followup OS readout later this year.

We’ll have to wait and see how that all fits in Roche pharma chief Daniel O’Day’s expectations that Roche “will dimensionalize the first-line lung cancer space in 2018.”

“Until now, there have been few treatment advances for squamous non-small-cell lung cancer. Our findings may provide a new potential treatment option for this type of cancer,” said lead study author Robert Jotte. “We used to think that chemotherapy just knocked down the patient’s immune system and that it would be irrational to combine it with immunotherapy, but growing research, including this study, shows that chemotherapy can help trigger the immune response to the tumor, helping the immunotherapy treatment work better.” 

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Research Scientist - Immunology
Recursion Pharmaceuticals Salt Lake City, UT
Director of Operations
Atlas Venture Cambridge, MA

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