Gilead Sciences Inc’s Trodelvy extended by 1.5 months, or 34 per cent, the length of time women with advanced stages of the most common type of breast cancer lived without their disease worsening, according to late-stage trial data presented on Saturday (Jun 4).
The Phase III study compared Trodelvy to chemotherapy in 543 patients with hormone-sensitive tumours that test negative for a receptor called HER2 and who had stopped responding to at least two earlier lines of therapy.
The data, presented in Chicago at the annual meeting of the American Society of Clinical Oncology (ASCO), show progression-free survival for the Trodelvy group of 5.5 months compared with four months before the disease began to worsen for chemotherapy patients.
“Some will argue is that really a clinically-meaningful difference?” Dr Julie Gralow, ASCO’s chief medical officer, told Reuters. “The real point here is we have proof of principle this drug works … I’m sure it will be used.”
Trodelvy, also known as sacituzumab govitecan, uses a tumour-targeting antibody to deliver an anti-cancer drug.
Patients with hormone-sensitive, HER2-negative metastatic breast cancer are treated with endocrine therapy combined with targeted drugs. As the disease becomes resistant, treatment is limited to chemotherapies with increasingly short durations of benefit.
At the study’s first analysis, Trodelvy patients lived a median 13.9 months, compared to 12.3 months for the chemotherapy group – a difference that was not statistically significant.
“We have to wait for that to mature,” Gilead Chief Executive Daniel O’Day told Reuters. “The final analysis for overall survival will most likely be in 2024 … but we’ll see if we take a look at it earlier.”
The most common adverse side effects reported for Trodelvy patients were low white blood cell counts and diarrhea.
O’Day said Gilead intends to seek US approval based on the recent data, pending routine discussions with the Food and Drug Administration.
Gilead in March said the study met its main goal of reducing the risk of cancer progression or death, but did not disclose any details. Shortly afterwards, the company wrote down by US$2.7 billion the value of its 2020 acquisition of the drug’s developer, Immunomedics.
Trodelvy is already FDA-approved for previously-treated metastatic triple-negative breast cancer and bladder cancer. It is being studied for use in a number of cancer types.
O’Day said Gilead expects to begin in the second half of this year a trial of Trodelvy as an initial treatment for hormone receptor-positive, HER2-negative breast cancer.
The drug has a US list price of US$2,188 per vial, but Gilead did not provide details of the average dose or duration of treatment.
Wall Street analysts, on average, expect annual sales of the drug will top US$2 billion 2026, according to Refinitiv.
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