Roche’s Tecentriq has chalked up a failure in ovarian cancer, leaving the disease still barren of a successful immunotherapy.
The addition of Tecentriq to Avastin and chemotherapies paclitaxel and carboplatin wasn’t better at fending off cancer progression than the Avastin-chemo combo in patients with newly diagnosed ovarian cancer, according to data presented Monday at the European Society of Medical Oncology's virtual congress.
The Tecentriq regimen merely prolonged the median time patients in the phase 3 IMagyn050 trial lived without disease worsening by less than a month. Its benefit was slightly better in those whose tumors bore the PD-L1 marker, cutting the risk of progression by 20%, but that figure still didn’t cross the statistical significance bar.
The Avastin-chemo pairing isn’t a powerful comparator to begin with. Despite an FDA nod to treat advanced ovarian cancer patients after surgery, the Avastin-chemo regimen failed to significantly extend patients’ lives over solo chemo in a clinical trial dubbed GOG-0218.
Roche’s still following up with IMagyn050 patients for a final life-extension analysis, though investigators are not optimistic at this point, noting that the first interim analysis didn’t show a significant survival benefit from the Tecentriq cocktail.
Tecentriq’s latest ovarian cancer trial flop follows two others by Pfizer and Merck KGaA’s rival PD-L1 inhibitor Bavencio. And, in the Keynote-100 trial, Merck & Co.’s PD-1 agent Keytruda triggered a response in merely 8% of patients who had received various prior lines of treatment, putting into question whether checkpoint inhibition has a role to play in this cancer type.
PARP inhibitors, on the other hand, have recently set themselves as the new standard of care for ovarian cancer. So drugmakers and researchers are trying to pair PD-1/PD-L1 therapies up with PARP drugs in this disease.
A Roche phase 1b trial is testing Tecentriq alongside Clovis Oncology’s Rubraca. The latter also teamed up with Bristol Myers Squibb in the phase 3 Athena trial, examining whether adding Opdivo to Rubraca as a maintenance treatment can prevent cancer from returning after initial response to first-line platinum-based chemo treatment.
The phase 1/2 Keynote-162 trial, combining Keytruda with GlaxoSmithKline’s Zejula, triggered an 18% response rate in patients with recurrent platinum-resistant ovarian cancer. Zejula was recently approved by the FDA as a first-line maintenance therapy for patients who responded to platinum chemo.
AstraZeneca, for its part, is testing its PD-L1 drug Imfinzi alongside Merck-shared PARP inhibitor Lynparza in the phase 3 DUO-O trial, just as Merck is also evaluating Keytruda with Lynparza in Keylynk-001 study in the first-line treatment and maintenance settings.