What the study showed, and for whom
AstraZeneca said its experimental stomach cancer drug helped patients whose disease had spread and who had already tried other therapies live markedly longer. The medicine, known as sone-ve and fully named sonesitatug vedotin, improved overall survival by five months versus chemotherapy and other treatments, and it doubled the time patients survived.
Patients treated after one prior regimen lived longer, and the benefit was greater when given after two earlier lines. Commenting on the two-prior-line setting, Salah-Eddin Al-Batran - who leads the Frankfurt Institute of Clinical Cancer Research as managing director - said the regimen is likely to become the favored option, noting he had no role in the study. He added that earlier use would need more data.
Presented Sunday at the European Society for Medical Oncology meeting, the trial failed to demonstrate a slowdown in disease progression. Susan Galbraith, who oversees AstraZeneca's oncology hematology research and development as executive vice president, said that determining progression in gastric cancer is often difficult.
Safety, the target, and rivals
Fewer patients on sone-ve stopped therapy due to side effects than on older medicines, and treatment-related deaths were roughly similar between groups. The drug targets Claudin 18.2, a protein in the stomach lining that is present in some gastric cancers. Astellas Pharma's Vyloy also goes after Claudin 18.2 but is limited to tumors with much higher expression, which narrows who can get it.
Competition around the target is building. In another group of stomach cancer patients, data presented at the congress showed Takeda's arcotatug tavatecan extended survival by over three months. The mechanism "really reduces the risk of any nausea, vomiting, and diarrhea," said Phuong Khanh Morrow, who leads Takeda's oncology therapeutic area unit.
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Inside the meeting, and AstraZeneca's broader oncology push
AstraZeneca also reported late-stage data at the meeting for Tagrisso combined with Orpathys, a medicine it developed with Hutchmed, in a subset of non-small cell lung cancer. Among patients whose tumors expressed a certain protein at high levels, the combination postponed progression by just over two months and added nearly five months of survival versus chemotherapy.
Galbraith said the results support AstraZeneca's view that antibody drug conjugates could displace chemotherapy in many tumors. Dave Fredrickson, executive vice president of the oncology business unit, said the company is in discussions with health authorities about the sone-ve data.
The bottom line for investors
AstraZeneca estimates sone-ve could generate $3 billion to $5 billion a year. Before the meeting, Bloomberg Intelligence analysts suggested the drug could reach as much as $2.2 billion annually if the survival benefit held up. The survival gain, narrower drop-out rate than older options, and a target with room to expand eligibility frame ADCs as a growing pillar in AstraZeneca's oncology portfolio.
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