In cancer, it's AZ vs. Roche, Afinitor vs. everything

Two big cancer stories today, and it's not even time for ASCO yet. First, a battle for Europe's lung cancer patients is brewing, as an old AstraZeneca drug gets a new lease on life from personalized therapy--and Roche aims for the same market. Second, Novartis is putting its new kidney cancer drug Afinitor through its paces in other forms of the disease. Are we looking at a new "pipeline in a drug" à la Avastin?

The AstraZeneca/Roche matchup gets underway as European regulators recommend a new indication for Astra's lung cancer therapy Iressa, Reuters reports. The new use? Targeted treatment for lung cancer patients with a particular gene mutation (in the epidermal growth factor receptor, or EGFR, for you science types). That's a coup for AstraZeneca, which had watched Iressa languish after a failed 2004 trial.

Too bad the promising indication surfaced after Roche launched a Phase III trial to test its cancer drug Tarceva as a first-line therapy for--you guessed it--the same group of patients. Though Tarceva has proved to be effective in all lung-cancer patients regardless of their EGFR status, both work best in tumors with mutations, Reuters says, so docs may want to use them as first-line treatments. But even though Iressa got to the EGFR party first, analysts said it's likely to remain sub-blockbuster, with $474 million in sales by 2014. "The two treatments are remarkably similar," a Deutsche Bank analyst told the news service, "and entering a carved up market without knock-out data is challenging."

Meanwhile, Novartis has barely ushered Afinitor [1] through the approval for kidney cancer patients, and it's already testing--or prepping to test--the drug in five other types of tumors. Patients with stomach, breast, and neuroendocrine tumors, among others, will get Afinotor as the company assesses just how effective the drug might be. So many simultaneous trials is a big risk, Novartis chief Daniel Vasella told Forbes, but given early results, it's not an irrational one. "This will be an important drug," he promises. We'll see.

- see the AstraZeneca release on Iressa
[2]- read the Reuters coverage [3]
- check out the Forbes story [4]

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