Cyramza·Tarceva therapy is expected to be proposed

Benefit from the combination of targeted cancer therapies, Concurrent discussion of hepatocellular carcinoma

Alternatives to EGFR exon 19 defects, etc., recorded 19.4 months of PFS

It is noteworthy whether the first combination option of targeted anticancer drugs to enter insurance coverage in the first-line lung cancer therapy will be possible.

 

According to related industries, first-line therapy for non-small cell lung cancer (NSCLC) VEGF receptor 2 antagonist Cyramza (Ramucirumab) and epithelial cell growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) Tarceva (Erlotinib), It is expected that the combination therapy of Tarceva (Erlotinib) will be presented to the Review Committee for Cancer Diseases of the HIRA this year, which will be held next week.

 

The combination therapy of the two drugs was approved by the EMA in January and the FDA in June.

 

The new combination targeting VEGF and EGFR is attracting attention because it has shown efficacy in mutant patients such as EGFR exon 19 deletion and exon 21 (L858R), which have been relatively weak so far.

 

Cyramza-Tarceva combination therapy confirmed the possibility of a through phase 3 RELAY trial.

 

In the study, the combined use of Cyramza and Tarceva reduced the risk of mortality by 40% compared to Tarceva alone, and progression free survival (PFS) was also 19.4 months, which was more than 7 months different from the control group.

 

Overall Survival (OS) has not yet been derived.

 

The median follow-up was 20.7 months, and the objective response rate was similar to Cyramza (76.3% in the combination group and 74.7% in the Erlotinib alone group, but the median duration of response was 18 months and 11.1 months.) It is also encouraging that about 70% of them included East Asians.

 

Lee Ki-hyung, professor of hematology and oncology at Chungbuk National University, said, "The EGFR-TKI target therapy, which was used for the treatment of non-small cell lung cancer of existing EGFR mutations, had a relatively low clinical effect in the exon 21 substitution group compared to the exon 19 defect group, so improvement was needed.

 

He added, "The dual inhibition mechanism of Cyramza-Tarceva combination therapy is expected to more effectively inhibit the growth of cancer cells compared to inhibiting one mechanism.

 

It is a remarkable treatment option in terms of overall treatment." Meanwhile, Cyramza was listed as refund type of risk sharing agreement (RSA) in second-line gastric cancer therapy in May 2018.

 

It is domestically approved to ▲second line therapy for advanced/metastatic gastric cancer or ▲metastatic colorectal cancer patients with advanced disease during or after treatment including Bevacizumab, Oxaliplatin, and Fluoropyrimidine, and combination therapy with FOLFIRI (Irinotecan, Folinic acid, 5-FU) ▲patients with metastatic non-small cell lung cancer whose disease progresses during or after chemotherapy including platinum as a combination therapy with Docetaxel.

 

Lilly (a developer of Cyramza ) is also in the process of insurance benefits about Cyramza monotherapy for patients with advanced or unresectable hepatocellular carcinoma that has a serum alpha fetal protein (AFP) of 400 ng/mL or more and patients not tolerated after Nexavar (Sorafenib) administration previously.