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Both Phase III Trials for Erlotinib Fail To Meet Primary Endpoints
The studies, conducted by Genentech in the United States and Roche in countries outside of the United States, evaluated Tarceva at 150 mg/day in combination with standard chemotherapy. Tarceva is a small molecule oral therapy designed to inhibit the tyrosine kinase activity of the HER1/EGFR signaling pathway inside the cell, which may block tumor growth.
"We are disappointed, but not completely surprised based on previously announced failures of EGFR inhibitors in this setting, that Tarceva in combination with chemotherapy did not improve overall survival as a first-line therapy in these studies. We believe that further work is needed to provide more insight into the role of EGFR inhibitors in this setting, either as a single agent or in combination with other targeted agents or chemotherapy," said Susan D. Hellmann, M.D., M.P.H., Genentech's executive vice president, Development and Product Operations, and chief medical officer. "In order to optimize the therapeutic potential of EGFR inhibition in NSCLC, we will use clinical data and conduct pre-specified analyses of tumor biopsy material to identify potential subsets of patients who may be more likely to benefit from treatment with Tarceva in combination with chemotherapy. The alliance of Genentech, OSI and Roche remains on track with our clinical development program and believes Tarceva may have utility in treating a variety of cancers."
The addition of Tarceva to chemotherapy was generally well tolerated and adverse events were similar to those previously reported with chemotherapy treatment and with Tarceva. Adverse events that occurred more often with Tarceva included diarrhea and rash.
About the Phase III Studies
The multi-center, randomized, controlled Phase III studies evaluated Tarceva at 150 mg/day in combination with standard chemotherapy in patients with stage IIIB/IV metastatic non-small cell lung cancer. The 1,050 patients enrolled in the TRIBUTE study were randomized to receive Tarceva plus standard chemotherapy (carboplatin and paclitaxel) or standard chemotherapy plus a Tarceva placebo. The TALENT study randomized 1,200 patients to receive either Tarceva in combination with standard chemotherapy (gemcitabine and cisplatin) or standard chemotherapy plus a Tarceva placebo.
Comprehensive Clinical Trial Program
These two Phase III studies are part of a comprehensive clinical development program in lung cancer, which includes a Phase III study of Tarceva as a single agent in a second-/third-line setting, a Phase II study of Tarceva as a single agent in bronchioloalveolar cell carcinoma (BAC) and a Phase I/II trial of Tarceva in combination with Avastin(TM) (bevacizumab).
"It is important to note that Tarceva has shown activity in a number of solid tumor types, including relapsed NSCLC, BAC and glioblastoma (brain cancer). Consequently, we remain optimistic about the alliance's prospects for success in the Phase III second-/third-line monotherapy trial in NSCLC and are encouraged by the response rates observed in the Phase I glioblastoma study, Phase II BAC study and in the combination trial with Genentech's Avastin," said Colin Goddard, Ph.D., chief executive officer of OSI.
The Phase III randomized study in second-/third-line metastatic NSCLC is assessing Tarceva as a single agent (150 mg/day) with survival as the primary endpoint. This 700-patient study is being conducted by OSI in collaboration with the National Cancer Institute Canada Clinical Trials Group (NCIC CTG), and completed enrollment in January 2003. This is the first single-agent controlled Phase III study of an EGFR-targeted agent designed to detect a survival advantage in second-/third-line NSCLC, and data are expected in early 2004.
The alliance, through OSI, is also conducting a Phase III trial evaluating Tarceva in 450 patients with previously-untreated metastatic pancreatic cancer. The Phase III study also is being conducted in collaboration with the NCIC CTG, and is a randomized, placebo-controlled study assessing the use of Tarceva in combination with gemcitabine, the only approved first-line chemotherapy treatment for pancreatic cancer. Improvement in patient survival is the primary endpoint in this study and data are expected in mid-2004.
Based on activity seen to date in a Phase I study of Tarceva in glioblastoma, Genentech initiated a Phase II study in glioblastoma earlier this year. The companies also announced that the U.S. Food and Drug Administration (FDA) has granted orphan drug status for Tarceva in patients with glioblastoma. This is the first HER1/EGFR-inhibitor to receive such classification.
About Non-Small Cell Lung Cancer
According to the World Health Organization, there are more than 1.2 million cases worldwide of lung and bronchial cancer each year, causing approximately 1.1 million deaths annually. According to the National Cancer Institute, lung cancer is the single largest cause of cancer deaths in the United States and is responsible for nearly 30 percent of cancer deaths in the country. Non-small cell lung cancer is the most common form of the disease and accounts for almost 80 percent of all lung cancer.
Tarceva is a small molecule designed to target the human epidermal growth factor receptor 1 (HER1) pathway, which is critical to cell growth in many cancers. HER1, also known as EGFR, is a key component of the HER signaling pathway, which often is involved in the formation and growth of numerous cancers. Tarceva is designed to inhibit the tyrosine kinase activity of the HER1 signaling pathway inside the cell, which blocks tumor cell growth. Tarceva currently is being studied as an oral dosage tablet.
Source: Genentech, Inc., Roche