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Roche drug cocktail doubles chance of holding lung cancer at bay

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37 per cent of patients in a closely watched clinical trial who received Tecentriq, Avastin and chemotherapy reached the one-year mark without their cancer progressing

Adding Roche’s immunotherapy Tecentriq to older drugs doubled the percentage of lung cancer patients who survived a year without their disease advancing, an outcome some experts labelled unprecedented.

37 per cent of patients in a closely watched clinical trial who received Tecentriq, Avastin and chemotherapy reached the one-year mark without their cancer progressing (PFS), according to data released recently. For patients getting only Avastin and chemotherapy, that fell to 18 per cent.

Roche’s announcement in November that its Impower 150 trial had broadly succeeded in first-line lung cancer patients helped spur a one-day, $12 billion rally in the Basel-based drug maker’s market capitalisation.

Severin Schwan, CEO, Roche sees an opportunity to leap-frog ahead as competitors still await their own lung cancer combination trial results.

“This is very, very promising,” Dr Solange Peters, the head of Medical Oncology at the Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland, said on the latest results.

“Doubling PFS (progression-free survival) at one year is something we have not seen with any targeted therapy in unselected patients to date.”

In a second significant trial result, Roche also released positive interim data from its recently approved haemophilia drug Hemlibra dosed every four weeks, saying the results were consistent with previous studies of the medicine dosed once a week or every two weeks.

Roche said it would submit the results from both studies to regulatory authorities around the world.

Analysts said the ‘highly significant’ risk reduction from the study will help cement Tecentriq as a strong competitor to Merck’s Keytruda.

Roche is counting on $150,000-per-year Tecentriq to help replace revenue from its $20 billion-per-year trio of Avastin, Herceptin and Rituxan whose patents have expired or will shortly, exposing them to cheaper competition.

According to estimates collected by Reuters, Tecentriq annual sales are seen topping $4.6 billion by 2023.

Lung cancer is easily the biggest oncology market, with about 220,000 people in the US due to be diagnosed this year and 155,000 seen dying from the disease often caused by smoking.

In Roche’s 1,202-patient study, patients getting Roche’s immunotherapy survived an average of 8.3 months without their disease getting worse, only modestly better than the PFS of 6.8 months for those getting chemotherapy and Avastin.
Still, analysts focussed more on the 38 per cent reduction in risk of disease progression or death in the Tecentriq group, well within the range they have said would signify a robust result.

For a set of patients who expressed a specific biomarker called ‘Teff’ that Roche is exploring to help identify people who may respond best, the results were more robust, with a 49 per cent risk reduction and PFS at 11.3 months for the Tecentriq group versus 6.8 months.

Roche, which said serious adverse events were seen in 25.4 per cent of patients getting the Tecentriq combination compared with 19.3 per cent in the Avastin-chemo group, is still awaiting Impower 150’s overall survival data in the first half of 2018.

Still, the trial’s head, Dr Martin Reck of Germany’s Lung Clinic Grosshansdorf, said those numbers ‘look encouraging.’

Tecentriq is already approved in bladder cancer treatment and for lung cancer patients who have failed chemotherapy.

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