Genentech, Inc. (NYSE:DNA) today announced that a Phase III study
(ATLAS) of Tarceva® (erlotinib) in combination with Avastin®
(bevacizumab) as maintenance therapy following initial treatment with
Avastin plus chemotherapy in advanced non-small cell lung cancer (NSCLC)
met its primary endpoint. The study was stopped early on the
recommendation of an independent data safety monitoring board after a
pre-planned interim analysis showed that combining Tarceva and Avastin
significantly extended the time patients lived without their disease
advancing, as defined by progression-free survival (PFS), compared to
Avastin plus placebo. A preliminary safety analysis showed adverse
events were consistent with previous Avastin or Tarceva studies, as well
as trials evaluating the two medicines together, and no new safety
signals were observed. Data will be submitted for presentation at a
future medical meeting.
"This is the second study to show that people with lung cancer who took
the daily pill Tarceva following initial treatment lived longer without
their cancer getting worse. We plan to discuss these data with the FDA
to determine next steps,” said Hal Barron, M.D., Genentech's senior vice
president, Development and chief medical officer. "Tumors use different
pathways to grow and these results showed that combining medicines
targeting two of these pathways instead of one delayed disease
progression.”
An earlier study, SATURN, showed Tarceva delayed disease progression
when given as a single agent immediately following treatment with
chemotherapy, compared to placebo. In ATLAS, patients were initially
treated with Avastin plus chemotherapy followed by the addition of
Tarceva to Avastin in the maintenance phase.
Avastin is currently approved as first-line treatment in combination
with carboplatin and paclitaxel chemotherapy for patients with locally
advanced, non-squamous NSCLC and Tarceva is currently approved as a
treatment for patients with advanced NSCLC who have progressed following
treatment with at least one prior chemotherapy regimen. Both therapies
have been shown to improve overall survival in these indications.
About ATLAS (AVF3671g)
ATLAS is a global, multicenter, randomized, double-blind,
placebo-controlled study that enrolled 1,157 patients with locally
advanced, recurrent or metastatic NSCLC. In order to evaluate patients
who are often excluded from Avastin-based clinical trials, patients with
treated brain metastases, tumors of squamous cell histology that were
not centrally located in the lung, and those taking blood-thinning
medications were eligible for this trial. Patients were initially
treated with four cycles of Avastin in combination with the
investigators’ choice of platinum-based chemotherapy regimens
(carboplatin/gemcitabine, carboplatin/paclitaxel, carboplatin/docetaxel,
cisplatin/vinorelbine, cisplatin/docetaxel or cisplatin/gemcitabine). If
their cancer did not progress and they did not experience significant
toxicity, patients were then randomized (n=768) to receive maintenance
therapy with Avastin plus Tarceva or Avastin plus placebo until disease
progression.
The study’s primary endpoint of PFS, as determined by investigators, was
defined as the length of time from randomization to disease progression
or death from any cause. PFS assessment began from the start of the
maintenance phase of the study after initial treatment with four cycles
of Avastin and chemotherapy. Secondary endpoints included overall
survival, incidence of all adverse events and selected Grade 3 or
greater adverse events and incidence of treatment discontinuation for
reasons other than disease progression.
About Lung Cancer
According to the American Cancer Society (ACS), lung cancer is the
single largest cause of cancer death among men and women in the U.S. and
nearly 162,000 Americans died from the disease in 2008. Most people with
lung cancer are diagnosed with advanced stage disease that cannot be
surgically removed or has spread to other parts of the body. The
majority of people with advanced lung cancer survive less than one year.
NSCLC is the most common type of lung cancer.
About Avastin
Avastin is a biologic antibody designed to specifically inhibit the
vascular endothelial growth factor (VEGF) protein that plays an
important role in the development and maintenance of blood vessels, a
process known as angiogenesis. VEGF is a potent activator of
angiogenesis throughout the lifecycle of a tumor and is thought to be
critical to a tumor's ability to grow and spread in the body
(metastasize). Avastin is indicated for the first- and second-line
treatment of metastatic colorectal cancer in combination with
intravenous 5-FU-based chemotherapy and for the first-line treatment of
unresectable, locally advanced, recurrent or metastatic non-squamous
NSCLC in combination with carboplatin and paclitaxel.
Avastin Safety
The most serious side effects associated with Avastin across all trials
were gastrointestinal (GI) perforation, slow wound healing, severe
bleeding, formation of an abnormal passage from parts of the body to
another part, blood clots, severe high blood pressure, nervous system
and vision disturbances, reduced white blood cell counts, kidney
malfunction and congestive heart failure. The most common serious
adverse events that may have occurred for Avastin for first- and
second-line metastatic colorectal cancer and first-line non-small cell
lung cancer included reduced white blood cell counts, tiredness, high
blood pressure, infection, severe bleeding, weakness, abdominal pain,
pain, blood clots, a brief loss of consciousness, diarrhea,
constipation, nausea, vomiting, dehydration, blockage of the bowel,
numbness and tingling in fingers and toes, nervous system disturbances
and headache. For full Prescribing Information and Boxed Warnings for
Avastin, visit http://www.avastin.com.
About Tarceva
Tarceva is a once-a-day pill that targets the epidermal growth factor
receptor (EGFR) pathway. Tarceva is designed to inhibit the tyrosine
kinase activity of the EGFR signaling pathway inside the cell, one of
the critical growth factors in NSCLC and pancreatic cancers. Tarceva is
indicated as a monotherapy for patients with locally advanced or
metastatic NSCLC whose disease has progressed after one or more courses
of chemotherapy. Results from two multicenter, placebo-controlled,
randomized Phase III trials conducted in first-line patients with
locally advanced or metastatic NSCLC showed no clinical benefit with the
concurrent administration of Tarceva with platinum-based chemotherapy
(carboplatin and paclitaxel or gemcitabine and cisplatin) and its use is
not recommended in that setting.
In pancreatic cancer, Tarceva is indicated in combination with
gemcitabine for the first-line treatment of patients with locally
advanced pancreatic cancer, pancreatic cancer that cannot be surgically
removed or pancreatic cancer that has spread to distant body organs.
Tarceva Safety
There have been infrequent reports of serious Interstitial Lung Disease
(ILD)-like events, including fatalities, in patients receiving Tarceva
for treatment of NSCLC, pancreatic cancer or other advanced solid
tumors. Cases of hepatic failure, hepatorenal syndrome, acute renal
failure (all including fatalities), and renal insufficiency have been
reported during use of Tarceva. When receiving Tarceva therapy, women
should be advised against becoming pregnant or breastfeeding. Tarceva is
pregnancy category D. The most common adverse reactions in patients with
NSCLC receiving Tarceva monotherapy were rash and diarrhea. The most
common adverse reactions in patients with pancreatic cancer receiving
Tarceva plus gemcitabine were fatigue, rash, nausea, anorexia and
diarrhea. For full Prescribing Information for Tarceva, visit http://www.tarceva.com.
About Genentech
Founded more than 30 years ago, Genentech is a leading biotechnology
company that discovers, develops, manufactures and commercializes
medicines for patients with significant unmet medical needs. The company
has headquarters in South San Francisco, California and is listed on the
New York Stock Exchange under the symbol DNA. For additional information
about the company, please visit http://www.gene.com.