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AstraZeneca has received two separate recommendations from England’s National Institute for Health and Care Excellence (NICE) for the use of its lung cancer treatments, Tagrisso (osimertinib) and Imfinzi (durvalumab), within England and Wales’s National Health Service (NHS).
Tagrisso has been recommended as an adjuvant therapy following complete surgical resection in adults with stage 1B to 3A non-small cell lung cancer (NSCLC) whose tumours have epidermal growth factor (EGFR) exon 19 deletions or exon 21 substitution mutations.
The NICE decision was supported by data from the Phase III ADAURA trial (NCT05120349), which demonstrated that post-surgical treatment with Tagrisso reduced the relative risk of disease recurrence or death by 83% compared to placebo in patients with stage 2 to 3A EGFR-mutated NSCLC. At two years, 90% of patients receiving Tagrisso were disease-free, compared to 44% in the placebo group. Among patients with stage 1B to 3A disease, 89% administered with AstraZeneca’s treatment were alive and disease-free at 24 months compared to 52% in the placebo group.
Meanwhile, Imfinzi has been recommended in combination with the chemotherapy etoposide and either carboplatin or cisplatin for the treatment of adults with untreated extensive-stage small cell lung cancer (SCLC).
NICE’s decision was based on results from the Phase III CASPIAN trial (NCT03043872), which demonstrated that adding Imfinzi to standard chemotherapy provided a significant and sustained overall survival (OS) benefit. At three years, the Imfinzi combination reduced the risk of death by 29% compared to chemotherapy alone.
Lung cancer remains the most common cause of cancer-related deaths in the UK, and accounts for nearly 50,000 new cases annually, according to Cancer Research UK. A 2023 report from Frontier Economics estimated that lung cancer costs the UK economy £699m each year.
While AstraZeneca has established itself as a key player in lung cancer treatment, Tagrisso faces competition. Johnson & Johnson (J&J) announced updated results from its Phase III MARIPOSA trial (NCT04487080) earlier this month, which tested the combination of its lung cancer drugs Lazcluze (lazertinib) and Rybrevant (amivantamab-vmjw). J&J claims the combination demonstrated a statistically significant OS improvement over Tagrisso by more than one year, though detailed data has not yet been disclosed.
Despite the pressure from J&J, AstraZeneca anticipates strong commercial performance from its therapies. Tagrisso and Imfinzi are projected to generate global sales of $8bn and $7bn, respectively, by 2030, according to GlobalData’s Pharma Intelligence Center.