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AstraZeneca Joins Bristol-Myers' Run At Merck in Lung Cancer

(BioPharma Dive) Oct 28, 2019 - AstraZeneca said a combination of Imfinzi and chemotherapy kept lung cancer from getting worse in newly diagnosed patients better than chemotherapy alone. A triple combination of Imfinzi, chemo, and a second immuno-oncology agent called tremelimumab also performed better than chemo alone. Investors are closely watching the results from this trial, called POSEIDON, as it could make AstraZeneca competitive with Merck & Co. in the first-line lung cancer setting. A similar trial of Bristol-Myers Squibb's Opdivo also had positive results last week.

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H. Jack West, MD (Posted: October 29, 2019)

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This development is very likely to prove to be too little, too late for altering first line treatment patterns in advanced NSCLC. The combination of nivolumab/ipilimumab in CheckMate-227 has just been reported to improve not only PFS but OS (Hellman, NEJM), so another anti-PD-L1/CTLA-4 combination that has had a checkered past, with many failures, and thus far has only demonstrated a PFS benefit is not compelling in a setting in which we already have more excellent treatments than we can pursue. As I've previously said, "You don't bring a knife to a gun fight, and you don't bring PFS to an OS fight."

This result provides a bit more confidence in tremelimumab, or at least keeps it from eroding further, but I would place good money on this combination having close to no impact on first line treatment patterns in advanced NSCLC.

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