Oncologists channel Oliver, asking pharma for more NSCLC drugs, more resources, more research

U.S. oncologists treating non-small cell lung cancer (NSCLC) want more—more therapies, more resources for managing patients of color, more research into managing comorbidities and more tools to reliably predict treatment response.

The Cancer Research Institute (CRI) and Regeneron generated the lengthy wish list by working with The Harris Poll to survey 250 oncologists who treat people with advanced NSCLC. Insights into the drivers of NSCLC have fueled development of drugs against an alphabet soup of targets—ALK, EGFR, NTRK, ROS1 and more—and checkpoint inhibitors have improved outcomes outside of those genetic subpopulations.

Yet, the survey shows that, for all the progress, there remain major unmet medical needs in NSCLC. The survey found 17% of oncologists regard the current treatment options as excellent. Almost one-third of the respondents said there is room for more immunotherapy options in advanced NSCLC, a market in which Regeneron’s Libtayo competes with other checkpoint inhibitors such as Merck & Co.’s Keytruda. 

The desire for more therapies reflects the limitations of existing drugs, plus differences between patients that prevent a one-regimen-treats-all approach. Most (96%) of the oncologists said it is important to have multiple treatment options.

Almost 90% of the oncologists want to see more research into treating advanced NSCLC patients with comorbidities. High blood pressure and pulmonary disease are common in the population, affecting 45% and 44% of patients seen by the oncologists, respectively. Almost two-thirds of respondents said there are not enough resources on how to manage cardiovascular disease.

The oncologists also want more resources on managing brain metastases, people of color and patients aged 70 years and older. Chemotherapy remains part of the treatment of many patients with advanced NSCLC but a gentler regimen, featuring fewer drugs or replacing them with radiation therapy, is needed in patients with poor overall health.

NSCLC is a growth area for Regeneron. The big biotech has made cutaneous squamous cell carcinoma its main Libtayo indication but is also making inroads into NSCLC. Lung cancer was a driver of a 62% jump in sales of the checkpoint inhibitors in the third quarter. Regeneron is also advancing an EGFRxCD28 costimulatory bispecific antibody as a potential treatment for EGFR-mutant NSCLC.