AstraZeneca’s Imfinzi combo fails spectacularly in non-small cell lung cancer

Az’s immune-oncology combination of Imfinzi and tremelimumab has failed to improve overall survival in a phase three trial, further undermining the chances of AZ presenting a challenge to Merck&co Keytruda in first non-small cell lung cancer.

The NEPTUNE study compared Imfinzi and tremelimumab with standard platinum- based chemotherapy in previously untreated patients with NSCLC. This was not the first trial to test this combination, initially there was clinical trial where it failed to make any significant difference however it showed signs of improvement in a particular subgroup of patients with a certain cancer biomarker. This prompted AZ to tweak the design of its trial to the present NEPTUNE trial which focuses exclusively on this group of patients.

AZ is obviously disappointed with the lack of improvement on OS compared to chemotherapy. With AZ’s head of Cancer, Josè Baselga, saying that the company “is fully committed to a deep analysis of the vast clinical and biomarker data from this trial to gain further insights to improve immune-oncology approaches for patients with metastatic non-small cell lung cancer.”

The result of this trial effectively removes the chances of Imfinzi challenging Keytruda. However, it is not all bad news for AZ, as Imfinzi does have a use as a maintenance therapy for locally-advanced NSCLC patients whose tumours cannot be removed surgically This approval came from its PACIFIC trial results last year, which helped to accelerate Imfinzi’s sales to $633m in the first half of the year.
It is also not the end of the road for Imfinzi, as AZ has another combination trial with Imfinzi and tremelimumab called POSEDION, with results to be read out at the end of the year. However, after this trial results, hopes have been significantly reduced. POSEDION is comparing Imfinzi, tremelimumam and chemo with an Imfinzi and chemo combination also comparing with just chemotherapy alone

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