By Peter Loftus
A drug sold by AstraZeneca PLC and Merck & Co. reduced the
recurrence of breast cancer in women with an early but aggressive
form of the disease, a long-running international study found.
The finding, which on Thursday was published online by the New
England Journal of Medicine and released at a major cancer-research
meeting, marked the latest advance in cancer treatments targeting
the genetic traits of tumors. It could expand the arsenal of
weapons against a hereditary form of breast cancer.
The result also helps validate the pharmaceutical industry's
investment in a pricey new class of drugs that target cancer cells,
known as PARP inhibitors.
AstraZeneca's pill, named Lynparza, has become one of the
company's top sellers, generating $1.8 billion in sales last year.
Rival GlaxoSmithKline PLC paid more than $5 billion in 2019 to
acquire the maker of another PARP inhibitor, Tesaro.
Lynparza carries a U.S. list price of about $14,449 per patient
monthly.
AstraZeneca plans to submit the data to regulators and request
regulatory approval of the use of Lynparza for early-stage BRCA
breast cancer, said David Fredrickson, executive vice president of
AstraZeneca's oncology unit.
PARP inhibitors work by blocking cancer cells from relying on a
survival tactic: the ability to repair their own DNA after their
DNA is damaged naturally or by other drug treatments. This, in
turn, contributes to cancer-cell death.
Health regulators have approved these types of drugs in recent
years to treat ovarian, breast, prostate and pancreatic
cancers.
The drugs have been found to be particularly useful against
cancers associated with harmful mutations in genes known as BRCA1
and BRCA2. Women with these hereditary mutations have a higher risk
of developing breast cancer, and often at a younger age than is
typical.
The BRCA mutations account for about 5% of the estimated 281,000
cases of breast cancer diagnosed annually in the U.S.
Overall, breast cancer is the second leading cause of cancer
death in women, causing about 43,600 deaths in the U.S. annually,
according to the American Cancer Society.
The Food and Drug Administration cleared Lynparza, in 2018, to
treat advanced-stage BRCA-mutated breast cancer.
The new study tested Lynparza in women at earlier stages of
breast cancer, at a time when it is potentially curable.
AstraZeneca sponsored the study and collaborated with Merck and
various research groups that run breast-cancer clinical trials.
Starting in 2014, researchers in the U.S. and 22 other countries
enrolled 1,836 women with early-stage BRCA1 or BRCA2 breast
cancer.
Before enrolling in the study, the women had undergone surgery
to remove tumors, and had received chemotherapy before or after
surgery aimed at preventing a recurrence of the tumor. They were at
high risk of recurrence based on the size of their tumors or
presence of cancer in lymph nodes.
The women also tested negative for the HER2 gene that is present
in some breast cancers.
Half of the women in the study were randomly assigned to take
Lynparza tablets daily for one year, while the other half got a
placebo.
At a median follow-up period of 2 1/2 years after the start of
treatment, Lynparza reduced the combined risk of recurrence of
cancer or death from any cause by 42% compared with a placebo, the
researchers found.
Researchers estimated that three years after the start of
treatment, 85.9% of the women who received Lynparza were living
without disease recurrence, compared with 77.1% of women who
received a placebo.
Lynparza also improved other measures of benefit, including the
time from the start of treatment until the development of tumors
distant from the original site in the breasts.
There were fewer deaths among the Lynparza patients than among
women who received the placebo, 59 versus 86, but the difference
didn't meet the study's criteria for statistical significance at
the time of follow-up.
Researchers said it may be possible at future dates to
demonstrate a statistically significant improvement in overall
survival.
"The early results are very encouraging that these therapies may
indeed result in increased cures for patients who develop cancers
with these mutations," said Dr. Charles Geyer, deputy director of
the Houston Methodist Cancer Center and one of the study's
leaders.
The presence of BRCA mutations can be detected with a blood
test. "This further highlights the importance of genetic testing in
appropriate patients, so that we know which patients will benefit
from this therapy, " ASCO President Dr. Lori J. Pierce said in an
online briefing with reporters.
Patients receiving Lynparza had higher rates of certain adverse
events including nausea, fatigue and anemia, compared with those
who received placebo, the study found. Researchers said this was
consistent with the safety profile of the drug for other uses.
AstraZeneca had previously disclosed in February that the study
was positive but didn't report the full results until Thursday,
ahead of being presented at the annual meeting of the American
Society of Clinical Oncology. The New England Journal of Medicine
also simultaneously published the results online.
AstraZeneca initially developed the drug. In 2017, it formed a
partnership with Merck to further develop and co-market the
drug.
Write to Peter Loftus at peter.loftus@wsj.com
(END) Dow Jones Newswires
June 03, 2021 17:14 ET (21:14 GMT)
Copyright (c) 2021 Dow Jones & Company, Inc.
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