AstraZeneca knows it's not leading when it comes to immuno-oncology. But if the company and its entry durvalumab get their shot at a "marketing battle," CEO Pascal Soriot likes his chances—even in the hotly contested lung cancer field.
Durvalumab, a PD-L1 immunotherapy, is up for its first nod in bladder cancer, but the lung cancer market is much larger—and three competitors are already jockeying for position there: Bristol-Myers Squibb's Opdivo, Merck & Co's Keytruda and Roche's Tecentriq. In the wake of a failure for BMS' solo Opdivo in first-line lung cancer—and a setback for an Opdivo-Yervoy combo in lung cancer—all eyes are on AZ's durvalumab and a similar durvalumab combo.
But the way company CEO Pascal Soriot sees it, there’s no reason to worry. The “total negative scenario,” meaning both the combo and solo durvalumab fail as non-small cell lung cancer treatments, is “low probability,” he said during AstraZeneca's Q4 earnings presentation. If AZ can snag durvalumab a monotherapy indication, “it becomes a marketing battle” with other immuno-oncology rivals.
On that front, Soriot is confident the British drugmaker can hang with the best of them. For one, AZ has “a very strong presence, historic presence” with prescribers in the lung cancer space, thanks to its reps’ work detailing Iressa and Tagrisso. “We know those physicians,” Soriot said.
Also, there’s 80% overlap between the treatment of lung cancer and bladder cancer, an indication for which durvalumab could win approval in Q2.
“The physicians who treat bladder cancer are more or less the same as those who treat lung cancer. So from a sales force effectiveness viewpoint, there's a very strong synergy,” he said.
AZ’s reps will certainly have their work cut out for them if durvalumab can nab a green light in lung cancer. Merck’s Keytruda has been on the lung cancer market since 2015, and it won a first-line monotherapy indication last October that—coupled with a Bristol trial flop—gave it a substantial market lead.
BMS is also gunning for its pairing of its PD-1 Opdivo and already-marketed Yervoy, a CTLA4 drug, that AstraZeneca may have to contend with if its PD-L1/CTLA4 pairing can reach the market.
AstraZeneca is hardly the only player to be targeting both the lung cancer and bladder cancer markets; Roche’s Tecentriq, currently a second-line lung cancer player, won a bladder cancer nod last May, while Opdivo picked its up Thursday. On Friday, Merck said the FDA had granted Keytruda a breakthrough designation in the second-line bladder cancer setting.