Is AstraZeneca finally ready to score with underachieving cancer drug tremelimumab?

Is AstraZeneca finally ready to score with underachieving cancer drug tremelimumab?

After years of failing to live up to expectations in a variety of cancer types, is AstraZeneca’s tremelimumab staging a better-late-than-never rally?

Less than a year ago came positive results from a trial in non-small cell lung cancer. Now, the drug could be nearing an approval in unresectable hepatocellular carcinoma (HCC).

The FDA has accepted AZ’s biologics license application (BLA) and granted a priority review of treme as a single-dose primer added to the company's PD-L1 inhibitor Imfinzi for treating first-line HCC. The company also has submitted a supplemental BLA for Imfinzi in this indication, it said.

AZ refers to the combo regimen as single tremelimumab regular interval durvalumab (STRIDE). It is due for a regulatory decision during the fourth quarter of this year following the use of a priority review voucher.

The BLA is based on results of a phase 3 trial that showed STRIDE achieved a 22% reduction in the risk of death versus Bayer’s Nexavar. After three years, 31% of those on STRIDE were still alive compared to 20% for the Nexavar group.

HCC is the most common type of liver cancer. In the U.S. roughly 26,000 people are diagnosed with it annually. Liver cancer is the third-leading cause of cancer death worldwide.

“The trial showed an unprecedented three-year overall survival in this setting,” Susan Galbraith, AZ’s EVP oncology and R&D, said in a release.

Competition in HCC is rigorous, however, with Roche’s Tecentriq and Avastin leading the way.

The FDA also is reviewing an Imfinzi-treme-chemo combination, which was found in the phase 3 Poseidon trial to extend the lives of patients with Stage IV or metastatic non-small cell lung cancer.

That win came after a series of defeats for AZ with the drug. In a phase 3 trial against extensive-stage small-cell lung cancer, treme added to Imfinzi and standard-of-care chemo added no survival benefit.

The drug has also posted trial flops in the first-line treatment of head and neck squamous cell carcinoma, in untreated NSCLC, where treme performed worse than Imfinzi alone, and in in front-line metastatic bladder cancer, where the Imfinzi-treme combo failed to top chemo alone.