- Roche AG's checkpoint inhibitor Tecentriq helped previously untreated patients with advanced lung cancer live longer when combined with its own Avastin and chemotherapy, according to updated results from a key study.
- Adding Tecentriq to a treatment regimen of Avastin plus carboplatin and paclitaxel significantly lengthened overall survival when compared to Avastin and chemotherapy alone, Roche reported Monday. Notably, patients experienced benefit across "varying levels" of PD-L1 expression.
- The results should boost the Swiss pharma's chances of competing with immuno-oncology rivals Merck & Co. and Bristol-Myers Squibb Company in the important non-small cell lung (NSCLC) cancer market.
In the immuno-oncology market, Tecentriq (atezolizumab) remains a distant third to both Bristol-Myers' Opdivo (nivolumab) and Merck's Keytruda (pembrolizumab).
Roche aims to close that gap through a broad program of late-stage studies across different lung cancer settings, chief of which is a Phase 3 trial called IMpower 150.
The study tests the combination of Tecentriq together with Roche's older drug Avastin (bevacizumab) plus chemotherapy as a first-line treatment for advanced cancer — a setting currently dominated by Keytruda.
Last year, Roche reported data from the trial that showed the Tecentriq combo regimen reduced the risk of cancer progression by 38% compared to Avastin and chemo alone. Keytruda's success as a first-line treatment, however, means Roche will need strong results from Tecentriq on both overall survival and progression-free survival in order for the drug to become a meaningful alternative.
Monday's update raises confidence in Tecentriq's competitiveness in the first-line setting. Roche did not disclose any specific data, but noted the combo delivered a survival benefit across subgroups.
"We have to await presentation of these data at an upcoming congress before we can assess the absolute scale of the benefit and how it compares with evolving competitor data," wrote Jefferies analyst Ian Hilliker in a March 26 note. "However, it is highly encouraging that the result is described as both a significant and clinically meaningful overall survival benefit."
Important clinical updates on both Keytruda and Opdivo are expected at the upcoming annual meeting of the American Association of Cancer Research.
Tecentriq did fall short on one measure, however. IMpower 150 enrolled patients into three arms: Tecentriq with Avastin plus chemo; Tecentriq plus chemo; and Avastin plus chemo. At the current interim analysis, just replacing Avastin with Tecentriq in the chemo regimen did not lead to a statistically significant survival benefit.
Roche said the study will continue as planned to the final analysis, which leaves open the chance of that comparison eventually reaching statistical significance.
Analysts at Cowen & Co expect the market share held by Keytruda, Opdivo and Tecentriq in the advanced lung cancer market to quickly converge to roughly 30% each by 2019.
Roche's ability to accomplish that will be helped by recent positive clinical results from another combination study of Tecentriq in a sub-type of NSCLC known as squamous cell. In that setting, Roche has a chance to be first to market with an approval of a PD-1/L1 inhibitor.