Lung cancer 20 years major breakthrough! Roche immunotherapy tecentriq EU approved, first-line treatment of extensive small cell lung cancer (es-sclc)!

September 7, 2019 / bioun / -- Roche, a Swiss pharmaceutical giant, recently announced that the European Commission (EC) has approved the combination of chemotherapy (carboplatin + etoposide) and tecentriq (atezolizumab) for the first-line treatment of adult patients with extensive small cell lung cancer (es-sclc) In the United States, the indications were approved by the FDA in March this year Tecentriq combined chemotherapy (carboplatin + etoposide) is the first and only cancer immunotherapy approved for the early treatment of es-sclc It is also the first new first-line treatment approved for es-sclc patients in the past 20 years, which shows the improvement of total survival (OS) and progression free survival (PFS) for the first time in more than 20 years This approval is based on the results of phase III clinical study impower 133 This study showed that compared with chemotherapy, tecentriq + chemotherapy significantly prolonged the overall survival time (median OS: 12.3 months vs 10.3 months; HR = 0.70, 95% CI: 0.54-0.91, P = 0.0069), and significantly improved the one-year OS survival rate (51.7% vs 38.2%) In addition, compared with chemotherapy, tecentriq + chemotherapy significantly reduced the risk of disease progression or death by 23% (median PFS: 5.2 months vs 4.3 months, HR = 0.77, 95% CI: 0.62-0.96, P = 0.017), and doubled the annual PFS rate (12.6% vs 5.4%) It is worth mentioning that this study is the first phase III clinical study to confirm that the first-line treatment of es-slcl based on cancer immunotherapy can significantly improve OS and PFS In this study, the safety of tecentriq combined with chemotherapy was consistent with that of the known tecentriq Dr Sandra horning, Roche's chief medical officer and head of global product development, said: "this approval makes tecentriq the first cancer immunotherapy available in Europe for the initial (first-line) treatment of es-sclc, marking an important step forward in the clinical treatment of this type of cancer Compared with the current standard nursing plan, tecentriq combined chemotherapy has been proved to improve the survival of patients Because of the refractory nature of the disease, this treatment progress is difficult to achieve until today " According to the World Health Organization (who), lung cancer is the leading cause of cancer death in the world, causing 1.76 million deaths every year, which means more than 4800 deaths every day There are two main types of lung cancer, non-small cell lung cancer (NSCLC) and SCLC Among them, SCLC accounts for about 15% of lung cancer cases, and most patients (70%) are diagnosed as "extensive stage (ES)" disease, that is, cancer has spread to the whole lung or other parts of the body, which generally means poor prognosis SCLC is distinguished from other lung cancer subtypes by its early occurrence of aggressive, fast-growing and metastatic diseases, which are often not found until the cancer progresses to the advanced stage Chemotherapy (combined with or without radiotherapy) has always been the standard first-line care plan However, most patients will relapse within one year, and the prognosis of the disease is very poor Only 6% of the patients survive within 5 years after diagnosis Tecentriq belongs to PD - (L) 1 tumor immunotherapy It is a protein named PD-L1 expressed on tumor cells and tumor infiltrating immune cells, and blocks its interaction with PD-1 and B7.1 receptors Tecentriq can activate T cells by inhibiting PD-L1 Tecentriq has the potential to be a basic combination therapy for cancer immunotherapy, targeted drugs and various cancer chemotherapy programs Up to now, tecentriq has been approved in the United States, the European Union and other countries in the world as a single drug therapy, as well as combined targeted therapy and / or chemotherapy, to treat various types of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), some types of metastatic urothelial cancer (MUC), PD-L1 positive triple negative breast cancer (TNBC) In the area of lung cancer, Roche is conducting nine phase III studies to evaluate tecentriq as a single drug therapy or combined with other drugs for the treatment of many different types of lung cancer The company has developed a wide range of development projects for tecentriq, including a number of ongoing and planned phase III studies involving lung cancer, urogenital cancer, skin cancer, breast cancer, gastrointestinal cancer, gynecological cancer, head and neck cancer Lung cancer market pattern: kestruda is the king of NSCLC, while tecentriq leads the field of SCLC At present, keytruda, the PD-1 tumor immunotherapy, occupies an absolute dominant position in the treatment market of non-small cell lung cancer (NSCLC) Small cell lung cancer (SCLC) is another competitive lung cancer market segment So far, three cancer immunotherapies have been approved by the US FDA for the treatment of SCLC, respectively: (1) Bristol Myers Squibb PD-1 tumor immunotherapy opdivo (odivo), which was accelerated on August 16, 2018; (2) Roche PD-L1 tumor Immunotherapy tecentriq, approved March 8, 2019; (3) keysruda, MSD, approved June 17, 2019 All of the three therapies belong to PD - (L) 1 tumor immunotherapy Opdivo and keytruda have the same indications They are used in patients with metastatic SCLC during or after chemotherapy with platinum and at least one other therapy Tecentriq is used in adult patients with extensive small cell lung cancer (es-sclc) treated with combination chemotherapy (carboplatin + etoposide) In addition, a cancer immunotherapy is rapidly approaching In June this year, AstraZeneca PD-L1 tumor immunotherapy imfinzi combined with chemotherapy first-line treatment es-sclc phase III study Caspian reached the main end point of significantly improving the overall survival period ahead of time in a pre-determined mid-term analysis Another phase III clinical study Adriatic is evaluating the use of imfinzi in the treatment of patients with limited SCLC after receiving concurrent radiotherapy and chemotherapy (CCRT) In July of this year, imfinzi was also granted the orphan drug qualification by FDA to treat SCLC Original source: European Commission approves Roche's tecentriq in combination with chemotherapy for the initial treatment of people with extended stage small cell lung cancer