TECENTRIQ

Connecting patients to an important advance in the management of lung cancer

Combining checkpoint inhibition with cytotoxic therapy during induction may be beneficial and potentially necessary to improve overall survival (OS) beyond that seen with the current standard of care.1

Lung cancer remains the leading cause of cancer death globally

Lung cancer remains the leading cause of cancer death globally, and extensive-stage small-cell lung cancer (ES-SCLC) or metastatic non-small-cell lung cancer (NSCLC) have been associated with poor outcomes despite recent advances in treatment.2,3

TECENTRIQ has been investigated in Phase 3 studies across both ES-SCLC and NSCLC.* Click a link to find out more.

First-line ES-SCLC

Second-line metastatic NSCLC

ES-SCLC; extensive-stage small-cell lung cancer; NSCLC, non-small-cell lung cancer.

*These Phase 3 studies are not representative of all Phase 3 TECENTRIQ studies.

Evidence-based treatment based on an extensive clinical trial programme addressing the unmet needs in patients with ES-SCLC and NSCLC

 

TECENTRIQ indications 

 

TECENTRIQ, in combination with nab-paclitaxel and carboplatin, is indicated for the first-line treatment of adult patients with metastatic non-squamous NSCLC who do not have EGFR mutant or ALK-positive NSCLC.4

 

TECENTRIQ, in combination with Avastin, paclitaxel and carboplatin, is indicated for the first-line treatment of adult patients with metastatic NSCLC. In patients with EGFR mutant or ALK-positive NSCLC, TECENTRIQ, in combination with Avastin, paclitaxel and carboplatin, is indicated only after failure of appropriate targeted therapies.4

 

TECENTRIQ as monotherapy is indicated for the treatment of adult patients with locally advanced or metastatic NSCLC after prior chemotherapy. Patients with EGFR mutant or ALK+ NSCLC should also have received targeted therapy before receiving TECENTRIQ.4

 

TECENTRIQ, in combination with carboplatin and etoposide, is indicated for first-line treatment of adult patients with ES-SCLC.4

IMpower133: A Phase 3 efficacy trial in first-line ES-SCLC

 

A Phase 3 study in patients (n=403) with extensive-stage SCLC randomised to receive induction therapy with carboplatin and etoposide in combination with TECENTRIQ or placebo, and then TECENTRIQ or placebo maintenance therapy until disease progression or unacceptable toxicity. Primary endpoints included OS and PFS.1

  • dddd

    Significant OS benefit with 30% reduction in risk of death versus carboplatin/etoposide alone1

    A statistically significant benefit in median OS in the population treated with TECENTRIQ + carboplatin/etoposide versus carboplatin/etoposide alone (12.3 months vs 10.3 months; HR=0.70; 95% CI: 0.54, 0.91)1,4

    Carbo/etop; carboplatin/etoposide.

  • dddd

    Significant improvement in PFS versus carboplatin/etoposide alone1

    A statistically significant improvement in PFS was also observed with TECENTRIQ + carboplatin/etoposide versus the control arm (5.2 months vs 4.3 months; HR=0.77; 95% CI: 0.62, 0.96).1

    Carbo/etop, carboplatin/etoposide.

  • dddd

    More than 50% of patients treated upfront with TECENTRIQ combination alive at 1 year1

    52% of patients treated up front with TECENTRIQ + carboplatin and etoposide were alive at 1 year vs 38% receiving carboplatin and etoposide. 1

    Carbo/etop; carboplatin/etoposide.

  • dddd

    More than 30% of patients treated with TECENTRIQ combination alive at 1.5 years5†

    34% of patients treated with TECENTRIQ + carboplatin and etoposide were alive at 1.5 years vs 21% receiving carboplatin and etoposide.5

    Carbo/etop; carboplatin/etoposide.
    As of data cut-off date 24th January 2019, median follow-up: 22.9 months.

TECENTRIQ: First major treatment advance for first-line ES-SCLC in over 20 years5,6

IMpower150: A Phase 3 efficacy trial in first-line non-squamous NSCLC7

A global 3-arm study in patients (n=1202) with chemotherapy-naïve non squamous metastatic NSCLC. Patients were randomised to receive TECENTRIQ + carboplatin/paclitaxel, TECENTRIQ + Avastin + carboplatin/paclitaxel, or Avastin + carboplatin/paclitaxel, respectively, until disease progression or unacceptable toxicity. Primary endpoints included OS and PFS in the intention-to-treat wild-type (ITT-WT) population (ie. EGFRwt and ALKwt).8

  • dddd

    TECENTRIQ in combination with Avastin + carboplatin/paclitaxel provides a durable survival benefit and rapid responses for chemotherapy naïve 1L metastatic non-squamous NSCLC patients7,8

    TECENTRIQ combination (TECENTRIQ + Avastin + carboplatin/ paclitaxel) more than tripled the PFS benefit at 18 months versus Avastin + carboplatin/paclitaxel alone (27% vs 8% (HR=0.59; 95% CI: 0.50, 0.70)) in the ITT-WT population.7,8

     

    Median OS was 19.2 months with TECENTRIQ combination vs 14.7 months with Avastin + carboplatin/paclitaxel alone (HR 0.78; 95% CI: 0.64, 0.96) in the ITT-WT population.4,7

    Carbo/pac; carboplatin/paclitaxel.

  • dddd

    TECENTRIQ: First cancer immunotherapy combination to demonstrate clinically meaningful survival in EGFR mutant metastatic NSCLC and liver metastases4,9

    OS benefit was observed in key 1L NSCLC patient segments with high unmet need:4,9,10,11

     

    ● Patients with sensitising EGFR mutations, no longer responding or not eligible for TKI therapy (not reached vs 17.5 months; HR=0.31; 95% CI, 0.11, 0.83)9

    ● Patients with liver metastases (13.3 months vs 9.4 months; HR=0.52; 95% CI: 0.33, 0.82)10

    ● Patients with bulky disease as described by multiple metastatic sites (mOS 17.6 months vs 12.5 months; HR=0.72, 95% CI: 0.58, 0.90)11

    Carbo/pac, carboplatin/paclitaxel.

  • dddd

    Durable responses with TECENTRIQ combination therapy4,9,10,11

    The majority of patients responded to TECENTRIQ combination (56.4% vs 40.2%) and responses were more durable than with Avastin + carboplatin/ paclitaxel.4

     

    Response rates also increased on the TECENTRIQ combination in patients with EGFR mutations (71% vs 42%), in patients with liver metastases (60.8% vs 40.2%) and in patients with bulky disease as described by multiple metastases (57% vs 40%) compared to Avastin + carboplatin/ paclitaxel.9,10,11

    Carbo/pac, carboplatin/paclitaxel.

Prof. Martin Reck provides a summary of the IMpower150 trial design and its key results.

  • View video transcript

    The IMpower150 trial was a very important trial while weighting the role of immunotherapy in untreated patients with advanced non-small cell lung cancer.

     

    And we had a particular question. And the question was whether we can add an immunotherapy to a combination of chemotherapy and anti-angiogenic treatment. And do you see an improvement of efficacy? And do you see manageable tolerability?

     

    This was a really large trial. More than 1,000 patients were recruited to the trial. And in principle, we were comparing a four-drug regimen, chemotherapy, carboplatin, paclitaxel, Avastin and the immunotherapy of atezolizumab, to the backbone, which was the chemotherapy and Avastin.

     

    The synergy between atezolizumab and the anti-angiogenic treatment with Avastin is very interesting. And we do have a couple of preclinical data suggesting that there might be an enhancement of the activity of the immunotherapy.

     

    And indeed, we had three co-primary endpoints, progression-free survival in two groups of patients and overall survival in the intent to treat populations in patients without oncogenic alterations. And in all of these three endpoints, we did see a significant improvement of efficacy, favouring the recombination of atezolizumab, chemotherapy and Avastin.

     

    Something which is very interesting is the fact that certain subgroups were included in the IMpower150.

     

    First, patients with pre-treated oncogenic alterations like EGF receptor mutations or ALK translocations were included. And this is the only trial so far because normally, we do not believe that immunotherapy does work in this group of patients with oncogenic alterations. We did observe a significant improvement in progression-free survival and overall survival also in this subgroup of patients with pre-treated oncogenic alterations for overall survival and progression-free survival for the combination of immunotherapy, Avastin and chemotherapy. And this is of clinical interest, in particular for patients where we do not have a T790M mutation after resistance, where we are really seeking for effective treatment opportunities.

     

    And the second subgroup was the group of patients with liver metastases. And these are patients with a very unfavourable prognosis. And also in this subgroup, we did observe a substantial and clinically meaningful improvement of efficacy favouring the combination of immunotherapy, anti-angiogenic treatment and chemotherapy.

     

    Overall, this is a very interesting, a very important trial and we will learn a lot of these results coming out of the IMpower150.

This video has been produced and funded by VJ Oncology. F. Hoffmann-La Roche Ltd did not participate in the filming or editing of this video. The video reflects independent opinions of the speaker. F. Hoffmann-La Roche Ltd has been given permission to publish this video here. Prof. Martin Reck has also provided explicit permission for this video to be presented here.

TECENTRIQ: First cancer immunotherapy combination to demonstrate clinically meaningful survival in EGFR mutant metastatic NSCLC and liver metastases4,9

IMpower130: A Phase 3 efficacy trial in first-line metastatic non-squamous NSCLC12

 

A Phase 3 study in patients (n=723) with chemotherapy-naïve unresectable stage IV NSCLC randomised to receive induction therapy with TECENTRIQ + carboplatin/nab-paclitaxel or carboplatin/nab-paclitaxel followed by TECENTRIQ or best supportive care/pemetrexed, respectively, until disease progression or unacceptable toxicity. Primary endpoints were PFS and OS in the intention-to-treat wild-type (ITT-WT) population (ie. EGFRwt and ALKwt).12

  • dddd

    TECENTRIQ in combination with chemotherapy demonstrated a significant 4.7-month improvement in median OS versus carboplatin and nab-paclitaxel alone in first-line metastatic NSCLC11

    Median OS of 18.6 months in patients treated with TECENTRIQ + carboplatin/nab-pac versus 13.9 months in patients receiving carboplatin/nab-pac (HR=0.79; 95% CI: 0.64, 0.98) in the ITT-WT population.

TECENTRIQ in combination with chemotherapy demonstrates a significant improvement in OS and PFS as first-line therapy in metastatic non-squamous NSCLC12

IMpower110: A Phase 3 efficacy trial in first-line non-squamous or squamous stage IV EGFR/ALK negative NSCLC12

 

A Phase 3 study in patients (n=572) with chemotherapy-naïve stage IV NSCLC randomised to receive induction therapy with TECENTRIQ or carboplatin (or cisplatin + pemetrexed [non-
squamous] or cisplatin + gemcitabine [squamous]) followed by TECENTRIQ or best supportive care (non-squamous) or pemetrexed (squamous), respectively, until disease progression or loss of clinical benefit. Primary endpoints included OS.12 

  • dddd

    TECENTRIQ monotherapy significantly improved median OS versus standard-of-care chemotherapy combination12

    Median OS of 20.2 months in patients treated with TECENTRIQ versus 13.1 months in patients receiving carboplatin or cisplatin + pemetrexed (non-squamous) or + gemcitabine (squamous): HR=0.595; 95% CI: 0.398, 0.890.12

TECENTRIQ monotherapy results in clinically meaningful survival outcomes in metastatic NSCLC without EGFR/ALK mutations4, 13

OAK: A Phase 3 efficacy trial in second-line non-squamous or squamous advanced/metastatic NSCLC13

 

A Phase 3 study in patients (n=1225) with locally advanced or metastatic NSCLC who progressed during or following a platinum-based regimen. Patients were randomised to receive TECENTRIQ or docetaxel until disease progression or unacceptable toxicity. The primary endpoint was OS.4,13

  • dddd

    TECENTRIQ monotherapy significantly improved median OS versus docetaxel in second-line advanced or metastatic NSCLC13

    Median OS of 13.8 months (95% CI: 11.8, 15.7) in patients treated with TECENTRIQ monotherapy versus 9.6 months (95% CI:8.6, 11.2) with docetaxel: HR=0.73; 95% CI: 0.62, 0.87

  • dddd

    >50% of patients treated with TECENTRIQ were alive at 1 year13

    An improvement in median OS was observed with TECENTRIQ versus docetaxel in both non-squamous (15.6 vs 11.2 months; HR=0.73; 95% CI: 0.60, 0.89) and squamous (8.9 vs 7.7 months; HR=0.73; 95% CI: 0.54, 0.98) NSCLC13

    • Improved OS was observed with TECENTRIQ at all levels of PD-L1 expression, including for patients with little or no expression (tumour cell and tumour infiltrating IC <1%: 12.6 vs 8.9 months; HR=0.75; 95% CI: 0.59, 0.96)13
    • ORR in the intension-to-treat population was comparable between treatment groups (14% vs 13%)13

TECENTRIQ demonstrates clinically meaningful OS in patients with previously treated advanced or metastatic NSCLC regardless of PD-L1 expression4,14

TAIL: A Phase 3/4 safety trial in a diverse patient population with NSCLC14

 

Patients with Stage lllb/IV NSCLC who experience disease progression after 1–2 lines of standard chemotherapy received TECENTRIQ 1200 mg IV q3w until disease progression or unacceptable toxicity. The primary endpoint was treatment-related safety. 14

TECENTRIQ monotherapy safety profile confirmed in a diverse, previously treated NSCLC patient population15

What this means for patients with lung cancer

  • Dr. John Conibear speaks about what recent advancements in immunotherapy mean for patient care.

    The future of small cell lung cancer care.

     

    What makes SCLC different from other types of lung cancer?

    Small cell lung cancer is the least common form of lung cancer that we treat. It makes up approximately 15% of lung cancer. Patients who present with small cell lung cancer tend to have large primary tumours and large lymph nodes within their chest.

    As a consequence of those large volume tumours and lymph nodes, they suffer with cough and breathlessness and often chest pain.
    The survival from small cell lung cancer is unfortunately much worse than non-small cell lung cancer even with standard of care treatment they only survive 10 months. As a consequence, there’s very few patients who live to 5 years.

     

    What are some of the challenges in treating these patients?

    The challenge that I face when I treat patients with small cell lung cancer is that the cancer itself grows quickly. The majority of patients that I treat have advanced incurable disease. As a consequence of that, I typically use combination chemotherapy. When I first meet patients with extensive-stage small cell lung cancer, I explain to them that their disease is likely to respond well to chemotherapy. In fact, many of those patients are impressed when they see the response they’ve had to their platinum doublet chemotherapy. Unfortunately though, many of them are devastated when they come back only after a short period of time later to find their disease has regrown and on receiving further treatment does not respond as well as it did.

    For over 20 years, combination chemotherapy has been the standard of care. Despite over 40 clinical trials, there hasn’t yet been any significant change to that standard of care.

     

    Tell us about what recent advancements in immunotherapy mean for patient care

    When you combine chemotherapy with immunotherapy you’re combining a treatment which can gain control of the disease quickly. The immunotherapy is then allowed time to mount an immune response which offers the patient durability. It’s now recognised that tumours with high mutational burden are the ones that respond best to immunotherapy drug treatment. Small cell lung cancer is just one of those tumours. As a consequence of that, when patients with small cell lung cancer receive immunotherapy, the immunotherapy encourages their immune system to attack their tumour cells.

     

    What are you most excited about when you look at how the treatment landscape is evolving for patients with SCLC?
    Over the past 10 years, there have been dramatic developments in the management of patients with lung cancer.

     

    Through advances in our understanding of lung cancer, we’ve seen new drugs such as immunotherapy, new types of chemotherapy, new targeted therapy but also advances in radiation delivery and even surgery.

     

    What do you anticipate for the future in SCLC?
    Patients with extensive-stage small cell have disease which grows quickly. You therefore need treatment which can gain control of the disease quickly, as with most new treatments that we see in oncology, we examine their benefits in the advanced setting.
    I’m hopeful that in future, those benefits will be examined in the limited stage setting of small cell lung cancer. Now, patients who I treat with lung cancer have a wealth of new treatment options, and it’s important that we personalise those treatment options to their disease. 

    View video transcript

Dr. John Conibear speaks about what recent advancements in immunotherapy mean for patient care.

  • Listen to Tommy, a lung cancer survivor who now uses his voice to raise awareness of the disease.

    I am very happy to be an advocate these days because so many good things have started to happen in the last three, four, five years. The numbers of survivors are increasing all the time, so it is very good to be able to say that. The same diagnosis for different people does mean different things. We realise when you talk to another cancer patient that we have something in common that we share, that nobody else can share. I’m not a doctor but I can tell you about the opportunities there are, there are a lot of new opportunities and I can compare to when I was diagnosed myself 15 years ago. There is next generation sequencing, there are targeted therapies, there are immunotherapies, there are a lot of options so you can live longer with your cancer.

     

    Continued trials are essential to help advance patient care. Lung Cancer Europe has for the last three years investigated how the lack of cancer care is in the European Union. We will help all the global lung cancer coalitions, we have enquiries all over the world where people think about lung cancer. If we are looking at the future, [there will be] even more medicines, more targeted therapies, and I think it is essential that if we’re going to fight lung cancer and beat it we have to have trials.

    View video transcript

Listen to Tommy, a lung cancer survivor who now uses his voice to raise awareness of the disease.

Resources

Explore more

Download therapy administration overview and dosing options

Curious to see more resources and download material?

Connecting YOU WITH YOUR PATIENTS

CONNECTING YOU WITH YOUR PATIENTS

At Roche, we believe in a shared purpose in improving the care and treatment of patients living with difficult to treat cancers. We understand and empathise with the demands you face managing the needs of these patients.

Roche is committed to exploring new treatment options to individualise treatment and meet patients’ needs. TECENTRIQ has proven efficacy as monotherapy as well as in combination with other medicines and we are committed to exploring new combinations to improve patient outcomes (ref. SmPC). 

TECENTRIQ is an anti PD-L1 cancer immunotherapy that specifically targets PD-L1 on tumour and tumour-infiltrating immune cells across a broad range of solid tumours. TECENTRIQ offers a pioneering, targeted treatment with proven efficacy and an acceptable tolerability profile (ref. SmPC). Please see the specific indications for more information.

Connecting TECENTRIQ and COMBINATIONS

CONNECTING TECENTRIQ AND COMBINATIONS

TECENTRIQ has proven efficacy as monotherapy as well as in combination with other medicines and we are committed to explore new combinations for better patient outcomes (ref. SmPC).

In many difficult-to-treat tumour types with a high unmet need, including metastatic urothelial carcinoma, triple negative breast cancer and lung cancer (non-small cell lung cancer and small cell lung cancer), TECENTRIQ has shown significant improvements in progression-free and/or overall survival (ref. SmPC). Importantly, treatment can be tailored (i.e., in combination with the standard of care, or different dosing schedules) according to the type of cancer and the patient’s individual needs (ref. SmPC).
Read SmPC for more details

The multiple indications of TECENTRIQ (ref. SmPC)
provide a wealth of data to inform treatment decision-making and deliver valuable reassurance when considering the needs of your patients with cancer. Please see the specific indications for more information.

Connecting PATIENTS TO THEIR LOVED ONES

CONNECTING PATIENTS TO THEIR LOVED ONES

TECENTRIQ treatment offers the potential to improve treatment outcomes and maintain patient quality of life in your difficult to treat cancer patients, so they can hopefully spend more time with their loved ones.

TECENTRIQ is approved in metastatic urothelial carcinoma, non-small cell lung cancer, extensive-stage small cell lung cancer and triple negative breast cancer (ref. SmPC).

  • References & Notes

    References & Notes

    1Horn L, et al. IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med. 2018;379:2220–9.

     

    2Farago AF, Keane FK. Current standards for clinical management of small cell lung cancer. Transl Lung Cancer Res. 2018;7 69–79.

     

    3Cheema PK, et al. Perspectives on treatment advances for stage III locally advanced unresectable non-small-cell lung cancer. Curr Oncol. 2019;26:37–42.

     

    4TECENTRIQ (atezolizumab), Summary of Product Characteristics. 27 March 2020. Available from: https://www.medicines.org.uk/ (Accessed April 2020).

     

    5Sabari JK, et al. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol. 2017;14:549–61.

     

    6Armstrong SA, Liu SV. Immune checkpoint inhibitors in small cell lung cancer: A partially realized potential. Adv Ther. 2019;36:1826–32.

     

    7Socinski MA, et al; IMpower150 Study Group. Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med. 2018;378:2288–301.

     

    8Socinski Mark A., et al., Interim analysis of IMpower150 shows improved overall survival with atezolizumab combination in the ITT population and across all subgroups, ASCO 2018 (Abstract 9002).

     

    9Reck M, et al. Atezolizumab plus Avastin and chemotherapy in non-small-cell lung cancer (IMpower150): key subgroup analyses of patients with EGFR mutations or baseline liver metastases in a randomised, open-label phase 3 trial. Lancet Respir Med. 2019;7:387–401.

     

    10Socinski Mark A., et al. IMpower150: Analysis of efficacy in patients (pts) with liver metastases (mets) 2019, ASCO 2019 (Abstract 9012).

     

    11Jotte R, et al. IMpower150: exploratory efficacy analysis in patients (pts) with bulky disease 2020, ASCO 2020 (Abstract e21637).

     

    12West H, et al. Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): A multicentre, randomised, open-label, Phase 3 trial. Lancet Oncol. 2019;20:924–37.

     

    13Spigel D, et al. IMpower110: Interim overall survival (OS) analysis of a Phase III study of atezolizumab (atezo) vs platinum-based chemotherapy (chemo) as first-line (1L) treatment (tx) in PD-L1–selected NSCLC. LBA78. Presented at ESMO 2019, Barcelona, Spain.

     

    14Rittmeyer A, et al; OAK Study Group. Atezolizumab versus docetaxel in patients with previously treated non-small cell lung cancer (OAK): A Phase 3, open-label, multicentre randomised controlled trial. Lancet. 2017;389:255–65.

     

    15 Ardizzoni A, et al. Primary results from TAIL, a global single-arm safety study of atezolizumab (atezo) monotherapy in a diverse population of patients with previously treated advanced non-small cell lung cancer (NSCLC). Ann Oncol. 2019;30(Suppl 5):v920–1.