The most prevalent kind of the disease, non-small cell lung cancer, has seen steady advancements in immunotherapies called checkpoint inhibitors during the past ten years. First, medications like Keytruda from Merck & Co., Opdivo from Bristol-Myers Squibb, and Tecentriq from Roche have become standard therapies for patients with metastatic disease. They are now more frequently made available this year, either before or after tumour removal operations.
For patients with primary lung cancer, the FDA has approved medication combinations comprising Opdivo and Tecentriq since January. Merck has stated that it intends to submit an application for Keytruda after disclosing the results of Phase 3 research in March. Imfinzi from AstraZeneca may soon join them after its launch, though it is still unclear how the medication stacks up against its rivals. Pathological full responses are a proxy for more meaningful outcomes, such as extending survival or slowing the spread of cancer, and the research hasn’t been running long enough to see how the medicine fared on those metrics.
When those figures are made public, it will be possible to determine whether immunotherapy for tumours has a greater impact than tumour removal procedures. Opdivo plus chemotherapy was examined for a brief nine-week period prior to surgery by Bristol Myers, who found a 37% decrease in the chance of relapse or mortality across the board. Following surgery, Roche and Merck investigated extended medication regimens. In the end, Roche achieved a risk reduction of 21% across the board and better outcomes with a 34% decrease in patients whose tumours express at least some of the protein PD-L1, which is linked to better therapeutic efficacy. Merck reported a risk reduction of 24% overall but a smaller average reduction of 18% in those with high PD-L1 levels. How long they can lengthen life has never been established with certainty. Research is continuing.
In contrast, AstraZeneca studied a 12-week regimen of Imfinzi and chemotherapy prior to surgery that was followed by up to 12 treatment cycles. Details of the study will be presented at a subsequent medical conference. While this is going on, Roche is also conducting a Phase 3 trial to evaluate a Tecentriq regimen that starts before surgery and continues after.
 A Snapshot
- The British pharmaceutical company reported on June 30th that Imfinzi, an immunotherapy from AstraZeneca, helped patients with early non-small cell lung cancer achieve the first of two major study objectives.
- After conducting a preliminary analysis, the study researchers discovered that patients who received chemotherapy and Imfinzi beginning before and trying to continue after surgical removal of a tumour demonstrated highly significant and constructive improvement compared to those receiving only chemotherapy in terms of what are known as pathological complete responses, or the absence of tumour cells on a scan. AstraZeneca withheld further information.
- The AEGEAN research will continue to examine how well the medicine mixture prevents cancer from returning, which is also one of its primary goals and a metric other businesses have used to justify authorization in early lung cancer. AstraZeneca will nonetheless communicate its findings with international health authorities in the interim.
