Tecentriq misses the mark in advanced ovarian cancer

Roche’s Genentech division has reported that Tecentriq, plus Avastin, was unable to improve progression-free survival as a front-line treatment for women with newly-diagnosed advanced ovarian cancer.

The phase 3 IMagyn050 study evaluated the addition of Tecentriq (atezolizumab) to Roche’s older treatment Avastin (bevacizumab) alongside chemotherapy (paclitaxel and carboplatin) in women with advanced-stage ovarian cancer.

Although the drug did not meet its primary endpoint of improvement in terms of progression-free survival, data for the co-primary endpoint of overall survival is currently immature and follow-up will continue until the next planned analysis. It seems unlikely, however, that Tecentriq will be able to improve overall survival if it had no benefit in progression-free survival, given that overall survival is considered to be a more robust indicator of benefit in cancer drugs.

“Ovarian cancer remains one of the most aggressive cancers and is difficult to treat in its advanced stages,” said Levi Garraway, chief medical officer and head of global product development.

“While we are disappointed by these results, we remain committed to improving outcomes for women living with this disease and are pleased that Avastin remains a key component in the treatment of front-line ovarian cancer,” he added.

Tecentriq is part of a new class of immunotherapy treatments, also known as PD-1/L1 inhibitors, that have transformed the market over the last few years.

Roche’s drug is approved in a range of cancer types, including urothelial carcinoma, triple-negative cancer and hepatocellular carcinoma. However, its dominant setting is in small cell lung cancer (SCLC), a niche that Tecentriq had to itself until the recent approval of AstraZeneca’s Imfinzi (durvalumab) in front-line extensive stage SCLC (ES-SCLC).

The FDA approval for Imfinzi makes AZ’s drug the first PD-1/PD-L1 inhibitor to challenge Roche’s Tecentriq SCLC. AZ is awaiting additional decisions on Imfinzi in first-line ES-SCLC in Europe and Japan before the end of the year, and the drug is already approved for this indication in Singapore. The company is also due to submit a regulatory filing in China later this year.

Lung cancer is otherwise dominated by rival PD-1 inhibitor Keytruda (pembrolizumab), marketed by Merck & Co/MSD. Keytruda is the leader in the non-small cell lung cancer (NSCLC) market, which accounts for the majority of lung cancer cases.

However, SCLC is one cancer type in which Keytruda does not seem to work – results from the KEYNOTE-604 trial showed that when the drug was added to chemotherapy, it was unable to improve overall survival.