AstraZeneca’s (LON:AZN) durvalumab/tremelimumab combination for first-line non-small-cell lung cancer (NSCLC) has a good chance of beating standard-of-care (SOC) chemotherapy in a Phase III trial, most oncologists said. Based on past data and the mechanism of action, the addition of tremelimumab is likely to increase the objective response rate (ORR) in an unselected population, which increases survival prospects, they explained.
Phase Ib data demonstrated responses in PD-L1 negative patients which is particularly encouraging given that many of these patients do not respond to PD-1/PD-L1 inhibitor monotherapy, experts noted. Coupled with the observation that patients on PD-1/PD-L1 inhibitors tend to have-long lasting responses, experts were largely optimistic regarding the combination’s potential efficacy.
Also, whilst PD-1/PD-L1 monotherapy such as durvalumab requires patient selection using factors such as PD-L1 expression to demonstrate efficacy over chemotherapy in the first-line setting, earlier data shows the addition of a CTLA-4 inhibitor such as tremelimumab may negate the need for patient selection, increasing trial success prospects, they said.
Analysts have noted that the first-line NSCLC market is worth USD 12bn in total, whilst noting optimism for the combination’s success.