OREANDA-NEWS. Data will be reported from across AstraZeneca’s industry-leading lung cancer portfolio at the World Conference on Lung Cancer (WCLC) 2015, beginning this weekend in Denver, Colorado. Presentations will feature 25 abstracts (including 9 oral and 4 late breaker presentations) on the company’s lung cancer pipeline, designed to address the unmet needs of patients with different forms of lung cancer.

AZD9291: Targeting resistance mechanisms in lung cancer

AZD9291 will be the focus of six oral presentations on its clinical activity in both first-line and previously-treated patients with epidermal growth factor receptor mutation (EGFRm) T790M advanced non-small cell lung cancer (NSCLC). The data are consistent with previously reported efficacy and safety results of AZD9291 in these treatment settings.

Antoine Yver, Head of Oncology, Global Medicines Development at AstraZeneca said: “The data presented at WCLC illustrate the breadth of our lung cancer research across multiple disease settings and lines of therapy, as we aim to develop a comprehensive portfolio of effective and durable treatments for patients. AZD9291 is moving through clinical development with unprecedented speed, and was recently granted US Priority Review designation in recognition of its potential to target the mutation that drives resistance to current treatments for EGFR mutation positive advanced non-small cell lung cancer in the majority of patients.”

In addition to AZD9291, AstraZeneca will also present results from the IRESSA® (gefitinib) Clinical Access Programme (ICAP), which provides data on the long-term safety and tolerability of the EGFR tyrosine kinase inhibitor in 188 US cancer patients outside the clinical trial setting. IRESSA® was approved by the US Food and Drug Administration (FDA) as a first-line treatment for EGFRm metastatic NSCLC in July 2015, and is already available in 91 countries worldwide.

Immuno-oncology (IO): Update on key clinical trials

Trial designs for the ongoing IO late-stage studies that will be presented at WCLC include:

  •  ATLANTIC (NCT02087423): A Phase II trial of durvalumab (PD-L1 mAb) as third-line treatment in patients with PD-L1 positive, locally advanced or metastatic NSCLC
  • ARCTIC (NCT 02352948): A Phase III trial of durvalumab monotherapy and in combination with tremelimumab (CTLA-4 mAb) versus standard of care in third-line metastatic NSCLC
  • PACIFIC (NCT02125461): A Phase III placebo-controlled trial of durvalumab compared to placebo in patients with locally advanced, unresectable, NSCLC following completion of treatment with chemoradiotherapy and no evidence of tumour progression.

Robert Iannone, Head of Immuno-Oncology, Global Medicines Development, at AstraZeneca said: “WCLC provides another opportunity for us to update the medical community on our extensive immuno-oncology development programme in lung cancer. We have made tremendous progress in developing immuno-oncology-based combination approaches, with nine pivotal studies planned or underway in NSCLC alone, which will provide us with a steady stream of research milestones in the coming months.”

The FDA has granted Fast Track designation to tremelimumab for the treatment of mesothelioma, an aggressive, rare form of cancer that affects the lining of the lungs and abdomen. Durvalumab was also granted Fast Track designation for patients with advanced NSCLC, who have received at least two prior systemic-treatment regimens, who do not have EGFR mutations or anaplastic lymphoma kinase (ALK) alterations, and have tumours that are determined to be PD-L1 positive.

AstraZeneca Pivotal Studies in Lung Cancer

Data presented at WCLC are part of AstraZeneca’s rapidly advancing lung cancer programme, which includes the following pivotal clinical trials and upcoming milestones.

Trial name

Medicine(s) line of therapy

Description

Status

Immunotherapies

ATLANTIC

Durvalumab, third line

A Phase II trial in third-line metastatic NSCLC assesses the efficacy of durvalumab in tumours that are PD-L1 positive in patients with locally advanced or metastatic NSCLC who have received two or more prior systemic treatments.

Ongoing

(recruitment completed for certain cohorts)


Data to be presented in 2016

ARCTIC

Durvalumab, third line

The Phase III trial in third-line metastatic NSCLC is recruiting patients and contains a randomised durvalumab monotherapy sub-study for PD-L1 positive tumours versus standard of care (SoC) and a sub-study with a concurrent-combination treatment with tremelimumab versus the contribution of components and SoC in patients with PD-L1 negative tumours.

Currently recruiting

MYSTIC

Durvalumab, tremelimumab, first line

A Phase III durvalumab-tremelimumab trial in first-line metastatic NSCLC, which is recruiting in PD-L1 unselected, EGFR/ALK wild-type patients and includes a sub-group analysis of PD-L1 positive and PD-L1 low/negative tumours. The primary endpoint is progression free survival (PFS) and the trial includes durvalumab monotherapy and the durvalumab-tremelimumab combination versus SoC.

Currently recruiting

NEPTUNE

Durvalumab, tremelimumab,

first line

A further Phase III durvalumab-tremelimumab study in the first-line metastatic NSCLC setting, versus SoC with overall survival (OS) as the primary endpoint; complements the MYSTIC PFS trial.

To be initiated

Name to be announced

Durvalumab,

first line

A third first-line Phase III NSCLC trial of durvalumab plus chemotherapy in PD-L1 unselected, EGFR/ALK wild-type NSCLC.

To be initiated

PACIFIC

Durvalumab,

Stage III unresectable

A Phase III trial assessing the PFS and OS with durvalumab compared to placebo in patients with locally advanced, unresectable, NSCLC following completion of treatment with chemoradiotherapy and no evidence of tumour progression.

Currently recruiting

AZD9291

AURA

AZD9291, first line, second line and beyond

PhaseI/IIopenlabel,dose escalation and expansioncohort studyto investigatethe safety andtolerability,pharmacokineticsandresponse totherapyof AZD9291in patientswith advancedNSCLCwhohad disease progressionfollowingtreatmentwith an approvedEGFR TKI.

Completed recruitment; trial ongoing

Phase I data presented at ESMO 2014, ELCC 2015 and ASCO 2015

AURA2

AZD9291, second line and beyond

Phase II, open-label, single-arm confirmatory trial to assess the safety and efficacy of AZD9291 in patients with advanced or metastatic NSCLC whose disease has progressed with previous EGFR-TKI therapy and whose tumours harbour an EGFR and T790M mutation.

Completed recruitment; trial ongoing

AURA3

AZD9291, second line

Phase III, open label, randomised study of AZD9291 versus platinum-based doublet chemotherapy for patients with locally advanced or metastatic NSCLC whose disease has progressed with previous TKI therapy and with the EGFR and T790M mutation.

Currently recruiting

CAURAL

AZD9291 in combination with durvalumab, second line and beyond

A Phase III, open label, randomised trial to assess the efficacy and safety of AZD9291 in combination with durvalumab versus AZD9291 monotherapy in patients with locally advanced or metastatic EGFR receptor T790M mutation-positive NSCLC who have received prior EGFR TKI therapy.

Currently recruiting

FLAURA

AZD9291, first line

A Phase III, double blind, randomised trial comparing the efficacy and safety of AZD9291 versus SoC EGFR-TKI treatment (gefitinib or erlotinib) in treatment-na?ve patients with locally advanced or metastatic EGFRm NSCLC.

Currently recruiting; trial design presented at ASCO 2015

TATTON

AZD9291 combinations

A multi-arm, Phase Ib trial investigating AZD9291 in combination with durvalumab, savolitinib (MET inhibitor; AZD6094) or selumetinib (MEK1/2 inhibitor; AZD6244, ARRY-142886) in patients with advanced EGFR mutant lung cancer that has progressed on previous EGFR TKI treatment.

Currently recruiting; initial trial results presented at ASCO 2015

Selumetinib

SELECT1

Selumetinib, second line

A phase III, double-blind, randomised, placebo-controlled trial to assess the efficacy and safety of selumetinib in combination with docetaxel, in patients receiving second-line treatment for KRAS mutation-positive locally advanced or metastatic NSCLC (Stage IIIB - IV)

Currently recruiting

About AstraZeneca in Oncology

Oncology is a therapeutic area in which AstraZeneca has deep-rooted heritage. It will be potentially transformational for the company’s future, becoming the sixth growth platform. Our vision is to help patients by redefining the cancer treatment paradigm and one day eliminate cancer as cause of death. By 2020, we are aiming to bring six new cancer medicines to patients.

Our broad pipeline of next-generation medicines is focused on four main disease areas - lung, ovarian, breast, and haematological cancers. These are being targeted through four key platforms – immuno-oncology, the genetic drivers of cancer and resistance, DNA damage repair and antibody drug conjugates.

About AstraZeneca

AstraZeneca is a global, innovation-driven biopharmaceutical business that focuses on the discovery, development and commercialisation of prescription medicines, primarily for the treatment of cardiovascular, metabolic, respiratory, inflammation, autoimmune, oncology, infection and neuroscience diseases. AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide.