Combatting aggressive lung cancer with second PBS win for AstraZeneca

Pharma News: Australians battling extensive-stage small cell lung cancer, an aggressive form of lung cancer with poor prognosis, have received a beacon of hope. AstraZeneca’s immunotherapy drug, Imfinzi (durvalumab) in combination with chemotherapy, has been included in the Pharmaceutical Benefits Scheme (PBS) from December 1, 2023. This announcement marks the second PBS listing for Imfinzi in this month, the first being for a rare gastrointestinal cancer.

Lung cancer remains a prevalent concern in Australia, with over 14,000 new diagnoses annually. Approximately 13% of these cases are small cell lung cancer, characterised by a 5-year survival rate of merely 5-10%.

Professor Nick Pavlakis, Medical Oncologist at Royal North Shore Hospital, expressed optimism regarding the new treatment’s impact on patient outcomes.

“Survival outcomes for patients with extensive-stage small cell cancer have shown improvement in recent years with the integration of immunotherapy alongside chemotherapy [etoposide and either carboplatin or cisplatin],” said Professor Pavlakis. “The inclusion of durvalumab on the PBS offers another immunotherapy drug option for treating patients with extensive-stage small cell cancer. This immune checkpoint inhibitor helps re-establish the anti-cancer immune response. It’s exciting to have another treatment option for these patients.”

The efficacy of Imfinzi in combination with chemotherapy was validated through the Phase III CASPIAN trial. The arm involving Imfinzi with chemotherapy revealed a 27% reduction in the risk of death (p=0.0047) compared to chemotherapy alone, with a median overall survival of 13.0 months versus 10.3 months. Additionally, the Imfinzi plus chemotherapy arm showed an increased objective response rate of 68% in comparison to chemotherapy alone at 58%. However, the trial’s second arm, testing AZ’s monoclonal antibody check point inhibitor Imjudo (tremelimumab), did not meet its primary endpoint when added to Imfinzi and chemotherapy.

Mark Brooke, CEO of Lung Foundation Australia, welcomed the inclusion of this combination treatment for extensive-stage small cell lung cancer.

“All Australians deserve equitable access to affordable treatment and this listing is a great
step to improving access to life-changing treatments for patients,” remarked Mr Brooke. “This listing caps off a landmark year for lung health, which included the Federal Government’s commitment to a National Targeted Lung Cancer Screening Program, a watershed moment.”

Ben McDonald, Country President of AstraZeneca Australia and New Zealand, commended the Government’s decision to list Imfinzi on the PBS.

“We welcome the Government’s initiative in reimbursing Imfinzi for Australians battling this devastating and often incurable disease,” said McDonald. “The reimbursement of Imfinzi builds on the Government’s commitment to lung cancer patients, following their $264 million investment in a national lung cancer screening program to increase diagnosis and save lives,” he said. “Thank you to the Australian clinicians and patients for their tireless efforts to ensure more treatment options are available on the PBS for treating different types and stages of lung cancer.”

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