Roche’s Tecentriq scoops up a big win in small cell lung cancer, grabbing the lead in frontline cases

Roche’s Genentech has scored a landmark success in treating small cell lung cancer, reporting that its PD-L1 checkpoint Tecentriq plus chemo helped patients live longer when they received the combo as a frontline therapy. And the score on IMpower133  should put it in the lead in that sector — for now. 

Falling on the heels of some setbacks, Genentech execs are reporting that their combination approach offered statistically significant results for both overall survival as well as progression-free survival. The beat over the control arm was also identified at an interim stage, allowing Roche to accelerate plans to get this into the hands of regulators.

The win here is crucial for Roche, which is playing catch-up with checkpoint leaders Bristol-Myers Squibb and Merck. And not all that effectively. The pharma giant needs to get out well ahead of the competition in key areas if they expect to hold on to their third-ranked position in the market, as AstraZeneca moves ahead with its advantage in one important niche of non-small cell lung cancer.

Sandra Horning

We won’t see Roche’s data until an upcoming conference, standard operating procedure in drug development.

Evercore ISI’s Umer Raffat and several other analysts have pegged IMpower133 as one of the most significant readouts in SCLC this year, with Bristol-Myers lining up Checkmate-451, where they are studying their I/O-I/O combo of Opdivo and Yervoy as a maintenance therapy.

AbbVie, meanwhile, recently conceded that their try against SCLC with Rova-T was a flop. And Merck also has failed to ignite much enthusiasm so far with its basket study results for Keynote-158 as a second-line therapy for SCLC.

Merck, meanwhile, is aggressively moving to challenge Roche here, with pivotal results being assembled in Keynote-604 for a combination of Keytruda and chemo after surging into a dominant position in frontline non-small cell lung cancer.

Now Merck is in the unusual position of being second. Patients, meanwhile, can look forward to some progress in a disease that has proved stubbornly difficult to beat.

“These are the first positive Phase III survival results for any immunotherapy-based combination in the initial treatment of extensive-stage small cell lung cancer, a particularly difficult-to-treat type of disease,” said Roche CMO Sandra Horning.

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VP Oncology Biology
Skyhawk Therapeutics Waltham, MA
Research Scientist - Immunology
Recursion Pharmaceuticals Salt Lake City, UT

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