Can AstraZeneca’s Imfinzi challenge Roche’s Tecentriq in Small Cell Lung Cancer

AZ has revealed impressive results from its Caspian trial for its immune-oncology treatment Imfinzi, revealing it improved Overall Survival by 27%.

AZ has been looking for approval for Imfinzi in combination with chemotherapy since June this year for Small Cell Lung Cancer (the most aggressive form of lung cancer.) At the World Conference on Lung Cancer (WCLC) lead investigator Luis Paz-Ares told delegates that Imfinzi plus etoposide chemotherapy achieved a mean Overall Survival (OS) of 13 months, compared to the OS of 10.3 months when just using chemo alone.

The question now facing AZ and regulatory agencies is whether Imfinzi can challenge Roche’s recently US approved Tecentriq. From the outset, the initial results are similar with Roche’s drug extending survival to 12.3months when added with chemotherapy. However where AZ differentiates itself is that the drug has shown an increased durability of response.

After 12 months, Progression Free Survival (PFS) was 17.5% compared to 4.7% with chemo, with the duration of the response also better at 22.7% versus 6.3% respectively. AZ Imfinzi’s also had the added advantage of the CASPIAN trial looking at multiple chemo options, giving physicians more choice and catering for varying changes in clinical practice.

Although this spells good news for AZ as it seems it will be able to challenge Roche in first line treatment for SCLC. Both competitors will be wary of Merck and Co, whose current treatment already reigns supreme in NSCLC (Non-Small Cell Lung Cancer), which has already been approved for use in third line treatment of SCLC and has an upcoming trial for first line SCLC.

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