ESMO: Lilly's Cyramza posts modest survival win in hard-to-treat bladder cancer group

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Eli Lilly's Cyramza will be competing against five I-O agents if it can snag a bladder cancer indication.

MADRID, Spain—Thanks to Eli Lilly’s phase 3 top-line announcement in May, industry-watchers knew that a Cyramza-chemo had topped a placebo-chemo combo at staving off bladder cancer progression among patients who had progressed through the first line of platinum-based chemo. What they didn’t know was by how much.

Over the weekend at the European Society for Medical Oncology (ESMO) meeting, the Indianapolis drugmaker revealed that Cyramza had prolonged median progression-free survival by 46%, keeping disease at bay for 4.07 months compared with placebo’s 2.76.

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And while “the numbers overall are rather small,” as an “impact on this very sick patient subpopulation,” they’re clinically significant, Levi Garraway, Lilly’s head of global development and medical affairs, said. Median overall survival in the setting is about seven months.

After first-line therapy, “the survival goes down, and it’s been difficult to kind of build on the backbones that are used in the second line,” he said, adding that this study was the first phase 3 trial to show a prolongation of progression-free survival in the post-platinum chemo setting.

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Of course, the bladder cancer space is increasingly crowded these days, thanks to FDA approvals for five PD-1/PD-L1 medsin other words, for all of them. Still, Garraway cited trial results showing that only about 15% to 21% of patients may benefit from the immuno-oncology therapies. “It’s still the case that the vast majority of bladder cancer patients are not benefitting. They progress on treatment or shortly thereafter,” he said.

There could be an opportunity to combine forces, though. Lilly already has “a number of studies” pairing Cyramza with immuno-oncology drugs, and while the company hasn’t yet “done extensive studies” in bladder cancer, “certainly I think this would be an area of interest in this cancer type,” Garraway said.

So far, Cyramza has been a bit of a mixed bag for Lilly. The med has racked up indications in metastatic non-small cell lung cancer, advanced stomach cancer and metastatic colorectal cancer that helped generate $614.1 million in sales last year. Trials of the drug in liver cancer and breast cancer have come up short, though.