Roche and Jazz's Zepzelca Combo Shows Promise in Small Cell Lung Cancer, But Room for Improvement Remains
Positive Phase 3 Results for Tecentriq-Zepzelca Combination
Roche and Jazz Pharmaceuticals have reported encouraging results from the phase 3 IMforte trial, evaluating the combination of Tecentriq (atezolizumab) and Zepzelca (lurbinectedin) as maintenance treatment for first-line extensive-stage small cell lung cancer (ES-SCLC). The study, which will be presented at the 2025 American Society of Clinical Oncology (ASCO) annual meeting, demonstrated a significant reduction in the risk of death by 27% compared to Tecentriq alone.
Patients receiving the combination therapy lived a median of 13.2 months, compared to 10.6 months for those on Tecentriq monotherapy. The combo also showed a 46% lower risk of cancer progression or death, with median progression-free survival times of 5.4 months versus 2.1 months for the Tecentriq-alone arm.
While these results represent a step forward in ES-SCLC treatment, ASCO Chief Medical Officer Julie Gralow, M.D., noted that there is still room for improvement, particularly in progression-free survival rates.
Safety Considerations and Future Directions
The addition of Zepzelca to the maintenance regimen increased the rate of treatment-related adverse events to 83.5%, compared to 40% in the control group. Grade 3 or 4 adverse events were also higher at 25.6% for the combo, versus 5.8% for Tecentriq alone. However, Jazz's R&D head, Rob Iannone, M.D., emphasized that most adverse events were manageable, making Zepzelca a suitable choice for maintenance therapy.
The pharmaceutical industry continues to explore novel agents for SCLC treatment, including the DLL3 drug class. Amgen's bispecific antibody Imdelltra has shown promise in this area, with ongoing trials evaluating its potential in combination with AstraZeneca's Imfinzi (durvalumab) for first-line maintenance treatment of ES-SCLC.
As the landscape of SCLC treatment evolves, the Tecentriq-Zepzelca combination represents a new paradigm for future drug development in this challenging disease setting. Jazz Pharmaceuticals has submitted the IMforte results to the FDA, potentially paving the way for expanded use of Zepzelca in first-line ES-SCLC treatment.
References
- ASCO: Roche, Jazz's Zepzelca small cell lung cancer win leaves room for improvement
Roche’s plan to bolster Tecentriq’s position in small cell lung cancer with Jazz Pharmaceuticals’ Zepzelca has paid off. But the pair’s success leaves room for improvement for future contenders.
Explore Further
What are the specific mechanisms by which Zepzelca enhances the efficacy of Tecentriq in the treatment of extensive-stage small cell lung cancer?
How does the safety profile of the Tecentriq-Zepzelca combination compare to current standard treatments for ES-SCLC?
What is the current stage of FDA review for Jazz Pharmaceuticals' submission of the IMforte trial results?
What are the potential market implications for the Tecentriq-Zepzelca combination if approved for first-line maintenance treatment in ES-SCLC?
How does Amgen's bispecific antibody Imdelltra work in combination with AstraZeneca's Imfinzi and how does it compare to the Tecentriq-Zepzelca regimen?