Pairing Roche’s PD-L1 inhibitor Tecentriq with Avastin reduces progression-free survival in patients with advanced kidney cancer by 26% compared to widely-used first-line treatment Sutent from Pfizer.
The new data from the IMmotion151 trial will be “discussed with global health authorities” including the FDA and EMA according to Roche, which first reported that the Tecentriq (atezolizumab) and Avastin (bevacizumab) regimen achieved one of its therapeutic objectives last December.
Patients on the combination had a progression-free survival of 11.2 months in the study compared to 7.7 months among those on Sutent (sunitinib). The study is also comparing overall survival in the two groups as a co-primary endpoint but those data – while ‘encouraging’ – are not quite ready, said the company.
The trial involved previously untreated patients with inoperable locally-advanced or metastatic renal cell carcinoma (RCC) whose tumours express the PD-L1 biomarker and will be presented at the American Society of Clinical Oncology’s Genitourinary Cancers Symposium later this week.
Roche’s chief medical officer Sandra Horning said the trial is the second to show the benefit of combining Tecentriq with Avastin, one of Roche’s blockbuster cancer drugs that still brings in big sales but is facing the threat of biosimilar competition in Europe and elsewhere. The study “provides further evidence to support the potential of this unique combination”, she added.
Last year, the IMpower150 trial of Tecentriq and Avastin showed that the combination improved PFS in patients with non-small cell lung cancer (NSCLC) compared to Avastin alone.
Roche is hoping that the combination data will help Tecentriq catch-up with the leaders in the PD-1/PD-L1 inhibitor category. Bristol-Myers Squibb’s Opdivo (nivolumab) was approved as a second-line treatment option for RCC in 2015 but posted mixed results in a trial involving previously-untreated patients as a monotherapy.
BMS is also looking at combining Opdivo with its CTLA4 inhibitor Yervoy (ipilimumab) in first-line RCC, and the results of the CheckMate-214 study showed that the combination was superior to Sutent with a statistically significant overall survival benefit and overall response rate, with the effects more pronounced in tumours that expressed PD-L1.
Meanwhile, Merck & Co’s Keytruda (pembrolizumab) is not yet approved to treat RCC but is in several clinical trials in this indication, including a phase III evaluation as a neoadjuvant therapy alongside surgery.