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Roche’s Tecentriq/Avastin combo improves survival in liver cancer

First regimen to achieve improved overall survival in ten years

Tecentriq

Roche says its combination of immunotherapy Tecentriq and older cancer drug Avastin has improved overall survival in liver cancer, the first regimen to achieve that objective in ten years.

The top-line result of the IMbrave150 study was reported last month, but Roche has now detailed the underlying data, revealing that Tecentriq (atezolizumab) plus Avastin (bevacizumab) reduced the risk of death by 42% compared to Bayer’s Nexavar (sorafenib) when given as a first-line therapy for hepatocellular carcinoma (HCC) patients ineligible for surgery.

Progression-free survival was also improved to 6.8 months from 4.3 months with Nexavar – a 41% improvement over the standard first-line option – and according to Roche IMbrave150 is the first phase 3 cancer immunotherapy study to show an improvement in overall survival in this setting. The results were presented at the ESMO Asia congress in Singapore.

Roche’s chief medical officer Levi Garraway – who took over from Sandra Horning on 1 October – said the company was working with regulators to bring the regimen to regulatory agencies around the world as quickly as possible.

HCC could be another important indication for Tecentriq as it plays catch-up in the cancer immunotherapy market with Merck & Co/MSD’s Keytruda (pembrolizumab) and Bristol-Myers Squibb’s Opdivo (nivolumab), and Roche has a chance of pipping its rivals to the first-line HCC market.

It’s also another endorsement for the Tecentriq/Avastin combination, which is viewed as a key pillar of Roche’s strategy to expand the use of its checkpoint inhibitor into new types of cancer.

Merck is testing Keytruda alongside partner Eisai’s kinase inhibitor Lenvima (lenvatinib) – already-approved for first-line HCC – in the Leap-002 trial, picking up a breakthrough designation from the FDA for this use in July.

BMS meanwhile reported data a few months ago from the CheckMate 459 trial which showed that Opdivo as a monotherapy improved on Nexavar in terms of response rates, but wasn’t able to achieve a significant improvement over Bayer’s drug on overall survival.

The company is also testing a combination of Opdivo and low-dose Yervoy (ipilimumab) – its CTLA4 inhibitor – in previously-untreated HCC in the CheckMate 9DW trial which uses Nexavar and Lenvima as comparator drugs.

More than 750,000 people worldwide are diagnosed with HCC every year, making it the most common form of liver cancer, and almost half of all cases occur in China.

The Tecentriq/Avastin combination is already approved for non-squamous non-small cell lung cancer (NSCLC) without EGFR or ALK mutations, and as a triple therapy with chemotherapy for EGFR or ALK mutation-positive non-squamous NSCLC.

While it still has a long way to go to challenge Keytruda and Opdivo in sales terms, Tecentriq has seen its growth accelerate on the back of recent approvals, rising 146% to around $1.3bn in the first nine months of this year.

Article by
Phil Taylor

25th November 2019

From: Research

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