ESMO: Is Roche's new Tecentriq data a match for Keytruda's 'lead and loyalty' in lung cancer?

BARCELONA—Right now, Merck’s Keytruda is the only immuno-oncology treatment approved solo in previously untreated non-small cell lung cancer. But Roche’s Tecentriq is looking to make it two.

Friday at the European Society for Medical Oncology annual meeting, the Swiss drugmaker presented data showing Tecentriq could extend patients’ lives by an additional 7.1 months compared with chemo, provided they didn’t have ALK or EGFR mutations and their tumors expressed high levels of biomarker PD-L1.

Those in the study’s Tecentriq arm saw their lives lengthened by a median 20.2 months, compared with 13.1 months for those in the chemo group.

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Patients with medium levels of PD-L1 also saw a numerical advantage on Tecentriq, living a median 18.2 months after treatment versus 14.9 months for the chemo arm. But the difference wasn’t statistically significant. Low-level PD-L1 patients didn’t see a benefit, as Roche reported earlier this month with its top-line results announcement, and the study will continue to see if Tecentriq can produce one down the line.

As Roche has said, its plan is to get the data to regulators around the world as quickly as possible in hopes of pinning down another front-line approval. Tecentriq joined Merck’s Keytruda late last year as the only members of the PD-1/PD-L1 with FDA clearance in previously untreated patients, with Roche snagging a go-ahead for a cocktail that also includes chemo and Roche’s Avastin.

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But just as it has in the combo field, Roche will have to go up against Merck’s Keytruda in a monotherapy race—one in which the New Jersey drugmaker has a head start of nearly three years. “The lead and loyalty for Keytruda among oncologists treating NSCLC are strong,” SVB Leerink analyst Daina Graybosch wrote to clients earlier this month.

While Tecentriq likely won’t pose a near-term threat to Keytruda’s “sales and dominance,” though, Graybosch and her colleagues see a potential approval increasing “long-term risk” to Merck’s immuno-oncology king.

The reason? “Companies with novel agents now have two options”—Merck and Roche—“to collaborate with in 1L NSCLC,” she wrote.