RE: Further evidence of TKI in combination therapy.28 Sep 2023 17:03
Johnson & Johnson said that its combination treatment staved off cancer progression for longer than AstraZeneca’s blockbuster Tagrisso as a first option for patients with a form of advanced lung cancer.
In the Phase III MARIPOSA study, J&J pitted its bispecific antibody Rybrevant and tyrosine kinase inhibitor lazertinib against Tagrisso alone. The study included 1,074 patients with locally advanced or metastatic EGFR-mutated non-small cell lung cancer.
J&J’s combo improved progression-free survival, but the verdict is still out on a key endpoint — overall survival — though J&J said Thursday there was a “trend favoring the combination” on that endpoint.
The final results of the study are expected to have major implications, as they could change what treatment option doctors give these lung cancer patients first and potentially shift billions of dollars in Johnson & Johnson’s direction. Tagrisso has been the go-to first option for this group of patients. It was AstraZeneca’s top-selling drug in 2022, bringing in $5.4 billion in sales — 12% of AstraZeneca’s total revenue.
Detailed data from MARIPOSA will be shared in October at the European cancer meeting ESMO.
“We believe peak sales potential for JNJ’s combo will, however, ultimately be dictated by the magnitude of PFS superiority, future overall survival results, and the relative tox profile. The bar for MARIPOSA is high because Tagrisso has a compelling first-line commercial profile, and physicians may choose to hold Rybrevant for second line or later use given additive toxicity concerns, and more cumbersome administration,” Leerink Partners analysts said in an August note.
AstraZeneca is working to fend off J&J’s advances. Earlier this month, the British drugmaker shared results from a study of Tagrisso in combination with chemotherapy. The study showed that the addition of chemotherapy delayed disease progression by 8.8 months compared to Tagrisso alone, but doing so also added substantial toxicities. Overall survival data from that study are also still immature.
In September, J&J also shared that Rybrevant and chemotherapy given with or without lazertinib improved progression-free survival in patients with advanced NSCLC and certain EGFR mutations who already tried Tagrisso.
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