Second failure of AstraZeneca

Fol­low­ing the news that the com­bi­na­tion did not improve over­all sur­vival ver­sus stan­dard-of-care chemother­a­py in metasta­t­ic head and neck can­cer pre­vi­ous­ly treat­ed with plat­inum-based chemother­a­py, it appears AstraZeneca’s invest­ment may not pay off, Chloé Thé­paut, Senior Oncol­o­gy Ana­lyst at Glob­al­Da­ta, a lead­ing data and ana­lyt­ics com­pa­ny, offers her view on the future of this combination:
Despite report­ing these dis­ap­point­ing results, AstraZeneca remains hope­ful for this com­bi­na­tion and announced that it expects to pub­lish data from the Phase III Kestrel study of Imfinzi + treme­li­mum­ab for head and neck can­cer patients who have not pre­vi­ous­ly received plat­inum-based chemother­a­py in the first half of 2019. How­ev­er, this data fol­lows neg­a­tive Phase III data from the Mys­tic tri­al of the same com­bi­na­tion in non-small cell lung can­cer (NSCLC), announced last month, sug­gest­ing that oppor­tu­ni­ties for suc­cess for the anti-PD‑1/an­ti-CTLA4 com­bi­na­tion are becom­ing limited.
Accord­ing to Glob­al­Da­ta, immuno-oncol­o­gy com­bi­na­tions such as Imfinzi + treme­li­mum­ab have seen a recent boom in devel­op­ment, with over 500 ongo­ing tri­als inves­ti­gat­ing approved check­point inhibitors with oth­er immuno-oncol­o­gy agents. Unless data in fur­ther indi­ca­tions, such as that expect­ed from the Kestrel tri­al, can demon­strate supe­ri­or­i­ty of Imfinzi + treme­li­mum­ab over the stan­dard-of-care, or show impres­sive effi­ca­cy or promis­ing safe­ty ver­sus com­pet­ing com­bi­na­tions, it is unlike­ly that AstraZeneca will have a dif­fer­en­ti­a­tion point suf­fi­cient for the com­bi­na­tion to be tak­en up onto the market.
An addi­tion­al chal­lenge that this com­bi­na­tion may face is that so far, the clin­i­cal suc­cess of treme­li­mum­ab has been lim­it­ed. Imfinzi monother­a­py appeared to pro­long over­all sur­vival more than the com­bi­na­tion in the Mys­tic tri­al, although nei­ther arm reached sta­tis­ti­cal sig­nif­i­cance, which has cast doubts on the anti-CTLA4 antibody’s efficacy.
AstraZeneca has, how­ev­er, enjoyed sig­nif­i­cant gains from its oncol­o­gy, car­dio­vas­cu­lar, renal, metab­o­lism and res­pi­ra­to­ry port­fo­lio, which led to sales growth of +19% year-to-date at the end of Q3 2018. So, although this data rep­re­sents a sig­nif­i­cant set­back for AstraZeneca, AstraZeneca could still reap the ben­e­fits from its broad port­fo­lio, which in 2018 led to sig­nif­i­cant sales growth for the company.