Roche’s Tecentriq Scores More Support for Lung Cancer Cocktail

Roche announced that its Phase III IMpower 133 clinical trial of Tecentriq (atezolizumab) plus carboplatin and etoposide chemotherapy in extensive-stage small cell lung cancer (ES-SCLC) met its co-primary endpoints. This is yet another win for the company’s hopes of bringing the first immunotherapy combination built-in Tecentriq for lung cancer.

IMpower133 is a Phase III, multi-center, double-blinded, randomized placebo-controlled trial evaluating the efficacy and safety of Tecentriq in combination with carboplatin and etoposide, standard chemotherapy, compared to the chemotherapy alone in patients who hadn’t had chemotherapy before who had ES-SCLC. There were 403 patients in the trial who were randomized equally to receive either the Tecentriq-chemo therapy or a placebo plus chemotherapy.

The interim data analysis showed that people who received the Tecentriq-chemotherapy combination lived significantly longer than patients that receive just the chemotherapy alone. The Tecentriq-combination also cut the risk of disease worsening or death (PFS) compared to the chemo-only group.

“These are the first positive Phase III survival results for any immunotherapy-based combination in the initial treatment of extensive-stage small cell lung cancer, a particularly difficult-to-treat type of disease,” said Sandra Horning, Roche’s chief medical officer and head of Global Product Development, in a statement. “The clinically meaningful results from the IMpower133 study add to the growing body of evidence demonstrating that Tecentriq-based combinations may be an effective treatment for different types of advanced lung cancer. We look forward to working with health authorities globally to bring this potential treatment option to people with this type of disease as soon as possible.”

The company didn’t release specific data, which it plans to provide at an upcoming medical conference. It did say the results were “clinically meaningful.”

Bruno Bulic, an analyst with Baader Helvea, told Reuters, “We see Tecentriq gaining momentum in lung cancer.” He also suggested that Roche’s “first mover advantage” for this indication could add $1.5 billion to sales of Tecentriq.

The drug brought in $140.6 million in revenue in this year’s first quarter, which is only about 10 percent what Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo brought in.

Reuters reported, “With rival medicine Keytruda from Merck beating Roche’s immunotherapy alternative to the punch in other, more common forms of lung cancer, the Swiss company is continuing efforts to prove Tecentriq’s merits in hopes of being first in rare types of the disease.”

This trial announcement represents the fourth positive Phase III lung cancer trial of a Tecentriq-based combination this year and the fifth overall. Roche has eight Phase III lung cancer studies ongoing that evaluate Tecentriq alone or in combination with other drugs across a variety of lung cancer types.

Lung cancer is the leading cause of cancer death worldwide. Every year 1.59 million people die of the disease, or more than 4,350 daily. There are two broad types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). SCLC makes up about 15 percent of all lung cancer cases. Survival rates for SCLC depend on the stage at the time of diagnosis. The first-year relative survival rate for individuals with stage I SCLC is about 31 percent. But, at stage IV, the five-year relative survival rate drops to about two percent.