Roche’s anti-PD-L1 drug Tecentriq has significantly improved survival in a trial involving elderly bladder cancer patients who were unable to receive cisplatin chemotherapy.
The results of the phase II IMvigor 210 study – reported at the American Society of Clinical Oncology (ASCO) meeting in Chicago – showed that previously-untreated patients taking Tecentriq (atezolizumab) lived an average of nearly 15 months. Typically, that patient group would only be expected to survive around 10 months.
The trial enrolled older patients too frail to tolerate cisplatin, a group that accounts for up to half of all patients with bladder cancer. Treatment with Tecentriq shrank tumours in around 25% of patients, with around 7% experiencing a total response.
Bladder cancer affects almost 430,000 people a year and kills around 165,000 worldwide, but has proved to be remarkably resistant to new drug therapy. The standard of care remains cisplatin and there have been few treatment advances over the last 30 years.
Tecentriq has just been approved in the US for the treatment of bladder cancer in patients whose disease has progressed during or after cisplatin chemotherapy, so the new trial data could support wider use of the drug in this form of cancer.
Cancer immunotherapies have brought “new momentum” to the treatment of bladder cancer, according to ASCO’s bladder cancer commentator Charles Ryan of the University of California, San Francisco (UCSF).
PD-1 inhibitors – including Merck & Co’s Keytruda (pembrolizumab) and Bristol-Myers Squibb’s Opdivo (nivolumab) – have also shown remarkable efficacy in bladder cancer, although as yet neither has been approved for treating bladder cancer.
At this year’s ASCO, for example, BMS reported data from a phase I/II trial in advanced bladder cancer patients previously treated with cisplatin, which showed a 24% response rate after nine months of follow-up.
“The fact that [Tecentriq] treatment appears safe for elderly patients, who too often have few good options, is all the more encouraging,” said Ryan.
A randomized clinical trial of atezolizumab as an adjuvant treatment for early-stage bladder cancer is also underway, according to Roche.
Analysts have predicted that sales of Tecentriq will eventually top $3bn a year assuming it wins additional approvals in other indications, notably triple-negative breast cancer and PD-L1-positive non-small cell lung cancer (NSCLC).