A rivalry is heating up between AstraZeneca and Johnson & Johnson in lung cancer.
The U.S. company's new drug combination beat Astra's best-seller Tagrisso in a study presented on Monday at Europe's biggest cancer conference. But the U.K. drugmaker's earlier rival findings show Tagrisso can be made effective when paired with chemotherapy.
J&J executives argued the findings would usher in a new era for lung-cancer care. Doctors at the conference said there isn't a clear winner because they will need to make decisions for each patient based on side effects, benefits and ease of care.
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"There's not going to be one easy answer," said
Doctors will have three options for patients' initial treatment: Tagrisso alone, the J&J combination and the Tagrisso-and-chemo combination, according to Piotrowska.
Investors have been hotly anticipating J&J's results, as they try to assess who will lead the market in coming years. First approved in 2015, Tagrisso is Astra's biggest drug and the cornerstone of its growing oncology portfolio. Analysts expect its sales to reach about $6 billion this year.
Both Tagrisso and J&J's new combination are targeted treatments for people with a change in a gene that controls production of the epidermal growth factor receptor protein. The EGFR mutation can spur a tumor to grow more quickly. More than half of Asian patients have the mutation, while for White patients, prevalence is around 15% to 20%, said
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For Le, who presented her own research on Tagrisso combinations at the
"The field is very exciting in that we start to have options," Le said. Toxicity — both in terms of physical side effects and the life challenge of taking an infused drug every two weeks — will be key as doctors try to parse who should get what option, she said. Also key will be whether certain subgroups of patients are helped more than others, she said.
The combination of J&J's Rybrevant and lazertinib caused more side effects than Tagrisso alone, including a higher incidence of rashes, infected fingernails and swelling of the limbs. Some 10% of patients on the J&J regimen had to stop treatment due to side effects.
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Astra's own findings on Tagrisso, presented last month at the World Conference on Lung Cancer, showed that adding chemotherapy extended the time before patients' cancer got worse, or they died, by 8.8 months. For J&J, the benefit was 7.1 months.
Both studies will require more follow-up before researchers can determine whether the new combinations could actually allow patients to live longer — a crucial efficacy measure called overall survival.
For a large number of patients, Tagrisso alone may still be "perfect," AstraZeneca Chief Executive Officer Pascal Soriot said in an interview. He suggested that the J&J regimen would have a place as a second-line treatment. "The side-effect profile is really a big problem."
