[Reporter's view] Fight between AZ/Janssen

for anticancer drugs

Since the discovery of EGFR gene mutation in non-small cell lung cancer patients in 2004, EGFR-targeted anti-cancer drugs have made remarkable progress over the past 20 years.

 

Tyrosine kinase inhibitors (TKIs) targeting this genetic mutation have been established as standard therapy through the first generation (Iressa), second generation (Giotrif ·Vizimpro), and third generation (Tagrisso).

 

Among them, Tagrisso is currently the only third-generation EGFR-TKI in the global market and has maintained its top position for more than five years without any competing drugs.

 

The strength of Tagrisso is that it shows better effects than the first and second generations, especially in brain metastasis, which lung cancer patients often experience.

 

Lung cancer is one of the most diagnosed cancers in the world, and EGFR is a major mutation in lung cancer, so global pharmaceutical companies are interested in it.

 

For this reason, pharmaceutical companies have measured the effect of EGFR mutations with various new drugs, and immuno-anticancer drugs are representative.

 

Immunotherapy has changed the paradigm of lung cancer treatment and brought about groundbreaking results.

 

However, even this was not as effective as expected in patients with EGFR mutations.

 

Only the recognition that EGFR-mutated lung cancer should be treated with targeted anticancer drugs has become more solid.

 

Since then, the attention of pharmaceutical companies has been focused on 'Next Tagrisso'.

 

AstraZeneca is betting on combination therapy using Tagrisso to protect its status, while competitors are betting on a combination therapy that has developed a new drug with a new mechanism.

 

In the second half of this year, a true swordsman battle will unfold between those who want to protect and those who challenge.

 

AstraZeneca plans to present the results of the FLAURA2 study, a phase 3 clinical trial comparing Tagrisso with chemotherapy alone, at the World Lung Cancer Society in September.

 

In October, Janssen will present at the European Society of Oncology (ESMO) the results of a phase 3 clinical MARIPOSA study comparing Rybrevant, an anti-cancer drug targeting EGFR exon 20 insertion mutation, and Leclaza, an EGFR-targeting anti-cancer drug introduced from Yuhan Corporation, compared to Tagrisso.

 

Currently, the two clinical trials that are directly compared with Tagrisso, the global first-line standard therapy, are both trying to change the standard treatment.

 

Of course, it was Janssen who had a greater ripple effect in case of success.

 

This is because it combines a TKI with a new mechanism called Rybrevant and a TKI similar to Tagrisso.

 

Global market research firm 'Evaluate Vantage' explained the market value of the two studies earlier this year, "The MARIPOSA study has two chances to beat Tagrisso by comparing Rybrevant + Leclaza combination therapy and Leclaza monotherapy, respectively, with Tagrisso." did.

 

The market research firm also commented, "Given the advantages MARIPOSA holds, the results of the FLAURA2 study may reduce the threat of Leclaza, but may not completely eliminate it." While AstraZeneca has already announced that it has demonstrated improvement in the primary endpoint in the FLAURA2 study, the market is paying keen attention to how much improvement Tagrisso + chemotherapy would have shown, and how the results of the MARIPOSA study, which are still veiled, will come out.

 

It is very likely that standard treatment options will increase in EGFR-mutated lung cancer.

 

This means that the patient's prognosis will be further improved.

 

In addition, within EGFR, customized treatment may be possible depending on the subtype and health condition.

 

This is good news for Korea, which has a high proportion of EGFR mutations.

 

So, the results of the second half are expected.