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AstraZeneca's Imfinzi Shows Sustained Benefit In Lung Cancer Study

(Reuters) Mar 17, 2020 - AstraZeneca Plc said on Tuesday longer-term data from a late-stage trial on its cancer drug, Imfinzi, in combination with chemotherapies showed sustained improvement in overall survival of certain lung cancer patients, sending its shares up 4%. The results confirm a previous set of data from the same study, which was published in September and had led the U.S. Food and Drug Administration to give the drug a priority review status two months later.

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H. Jack West, MD (Posted: March 17, 2020)

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The CASPIAN trial was positive for a survival benefit with durvalumab added to platinum/etoposide for first line treatment of extensive stage small cell lung cancer, which is now added to atezolizumab + carbo/etoposide as another option (a lateral move), at least once the FDA provides expected approval.
The story shouldn't be around positive results for durvalumab alone. That's old news, and it was never that interesting to clinical oncologists who already have an FDA-approved chemo/immunotherapy combination in first line SCLC, with chemo/durva offering no benefit over that.

The failure of the arm with durvalumab/tremelimumab added to chemotherapy, however, is another hit to this immunotherapy doublet that has demonstrated repeated failures in many settings. My opinion is that AZ needs to cut its losses and stop pursuing this combination. In the event that a rare trial comes up as positive with it, it will still suffer from being in the context of now a growing array of negative trials with durva/treme, and also with being compared to a nivolumab/ipilimumab combination that is very similar, except that nivo/ipi has demonstrated far more success.

As far as durva/treme is concerned, this dog won't hunt.

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