After a few long years of watching from the sidelines as its rivals dove into immuno-oncology’s most coveted market, AstraZeneca finally has a study win in previously untreated non-small cell lung cancer.
Monday, the British drugmaker said a combination of Imfinzi, CTLA4 candidate tremelimumab and chemo outperformed solo chemo at keeping patients’ cancer from progressing. Just how long the trio kept disease at bay remains to be seen; those details won’t come out until a future medical meeting. But in the meantime, AZ will be sharing them with regulators, it said.
RELATED: AstraZeneca mines for positives in Imfinzi’s failed Mystic lung cancer trial
The study victory is an important one for AstraZeneca, which hadn’t previously been able to show that the Imfinzi-tremelimumb combo could get it done in the first-line setting. The company failed to get in on the ground floor thanks to a big miss in its all-important Mystic study back in 2017, and this past August, the duo flopped another trial pitting it against standard-of-care chemo.
But just how much of a difference it’ll make in the market isn’t clear. Merck’s Keytruda-chemo combo has been cleaning up ever since the New Jersey drugmaker showed it could slash the risk of death by half, setting an extremely high bar for its rivals. And AstraZeneca doesn’t even yet have confirmation that its tandem can prolong lives; those are data it expects to read out in 2020.
AstraZeneca will also have to show a large enough benefit to justify adding a third drug into the mix. Doing so often ups toxicity levels for patients, not to mention the added costs.
RELATED: BMS nets another Opdivo lung cancer win—but it still has to beat Merck’s high bar
Those are the same concerns analysts broached earlier this month, when fellow PD-1/PD-L1 drugmaker Bristol-Myers Squibb unveiled a win for its own cocktail of Opdivo, CTLA4 drug Yervoy and chemo. But that trio has already proved it can extend lives, and it also involves a shorter course of chemo than AstraZeneca’s regimen does.
“This may or may not be a good thing–it can be predicted that more chemotherapy likely yields more toxicity, but will it yield more benefit?” Wolfe Research analyst Tim Anderson wrote in a note to clients at the time.
Only time will tell. For now, AZ is highlighting some positive differentiators: Its trial, called Poseidon, enrolled patients with squamous and non-squamous forms of NSCLC and used multiple choices of chemo regimen, increasing potential options for doctors.
