AstraZeneca furthers ambition to transform outcomes in early lung cancer and redefine metastatic breast cancer treatment at ASCO 2024

On May 22, 2024 AstraZeneca reported its ambition to redefine cancer care with new data across its industry-leading portfolio and pipeline at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting, 31 May to 4 June 2024 (Press release, AstraZeneca, MAY 22, 2024, View Source [SID1234643504]).

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More than 100 abstracts will feature 25 approved and potential new medicines across the Company’s diverse oncology portfolio and pipeline, including two late-breaking plenary presentations, a special late-breaking abstract session presentation and 15 oral presentations. Highlights include:

LAURA Phase III trial of Tagrisso (osimertinib) in unresectable, Stage III epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) after chemoradiotherapy (CRT) (Plenary LBA4).
ADRIATIC Phase III trial of Imfinzi (durvalumab) in patients with limited-stage small cell lung cancer (LS-SCLC) who had not progressed following concurrent CRT (cCRT) (Plenary LBA5).
DESTINY-Breast06 Phase III trial of Enhertu (trastuzumab deruxtecan) in patients with metastatic hormone receptor (HR)-positive HER2-low and HER2-ultralow metastatic breast cancer following one or more lines of endocrine therapy (LBA1000).
First-in-human, investigator-initiated trial of C-CAR031, a novel autologous armoured Glypican 3 (GPC3) targeting chimeric antigen receptor T cell (CAR-T) therapy, in patients with liver cancer. The CAR-T is based on AZD5851, a novel cell therapy designed by AstraZeneca (Rapid Oral Abstract 4019).
Two late-breaking presentations from the externally sponsored I-SPY2.2 Phase II trial of neoadjuvant datopotamab deruxtecan (Dato-DXd), alone and in combination with Imfinzi, in patients with breast cancer (LBA501 and LBA509).
Dave Fredrickson, Executive Vice President, Oncology Business Unit, AstraZeneca, said: "Our plenary data at ASCO (Free ASCO Whitepaper) show the pioneering role of our medicines in curative-intent lung cancer treatment and highlight progress toward our continued ambition to have a medicine for more than half of all patients treated for lung cancer by 2030. The overwhelming efficacy in the LAURA trial will add to the extensive body of evidence for Tagrisso in EGFR-mutated non-small cell lung cancer, and the impressive survival data from ADRIATIC will show the potential of Imfinzi to transform outcomes in limited-stage small cell lung cancer."

Susan Galbraith, Executive Vice President, Oncology R&D, AstraZeneca, said: "Data from our antibody drug conjugates at ASCO (Free ASCO Whitepaper) underscore the opportunity to replace traditional chemotherapy with these medicines for many patients as we expand their use to new populations. DESTINY-Breast06 results will demonstrate the potential to treat patients across a broader spectrum of HR-positive metastatic breast cancer with Enhertu, including those with HER2-ultralow expression who have never had access to HER2-directed therapy before. We’re also excited by the I-SPY2.2 efficacy and tolerability data for datopotamab deruxtecan plus Imfinzi, which will show the potential of combining antibody drug conjugates with immunotherapy in the early-stage setting."

Transforming treatment expectations across earlier-stage lung cancer settings

Several presentations will reinforce the Company’s progress toward moving lung cancer treatment to earlier stages of disease. These include:

A late-breaking plenary presentation showcasing progression-free survival (PFS) results from the LAURA Phase III trial evaluating Tagrisso in unresectable, Stage III EGFRm NSCLC after CRT. In February, high-level results showed a statistically significant and highly clinically meaningful PFS benefit for Tagrisso in this setting.
A late-breaking plenary presentation highlighting overall survival (OS) and PFS results from the ADRIATIC Phase III trial of Imfinzi in patients with LS-SCLC who had not progressed following cCRT. In April, high-level results from an interim analysis showed a statistically significant and clinically meaningful OS and PFS benefit for Imfinzi in this setting.
An oral presentation of an analysis from the ADAURA Phase III trial of Tagrisso in the adjuvant treatment of early-stage (IB, II and IIIA) EGFRm NSCLC, assessing the potential for circulating tumour DNA-based molecular residual disease to predict disease recurrence.
A rapid oral presentation of an exploratory analysis from the AEGEAN Phase III trial of Imfinzi-based treatment before and after surgery in patients with resectable early-stage (IIA-IIIB) NSCLC, evaluating efficacy in patients with N2 disease (cancer in the lymph nodes on the same side as the affected lung or between the lungs).
A poster presentation of updated OS, PFS and safety results from the COAST Phase II trial of Imfinzi in combination with novel immunotherapies oleclumab, an anti-CD73 monoclonal antibody, and monalizumab, an anti-NKG2A monoclonal antibody, in unresectable, Stage III NSCLC, supporting the PACIFIC-9 Phase III trial in this patient population.
In metastatic lung cancer, the Company will present data that underscore its commitment to extending the benefits of antibody drug conjugates (ADCs) to more patients. A poster presentation will share updated safety and efficacy results, including by PD-L1 expression, from the TROPION-Lung02 Phase Ib trial of datopotamab deruxtecan plus pembrolizumab with or without platinum chemotherapy as 1st-line treatment for patients with advanced NSCLC without actionable genomic alterations. These data build on previously presented results from the TROPION-Lung01 Phase III trial demonstrating the potential of this novel ADC in advanced disease. Datopotamab deruxtecan in combination with immunotherapies is being further explored in multiple Phase III trials in this setting, including AVANZAR, TROPION-Lung07 and TROPION-Lung08.

Redefining the breast cancer treatment landscape with ADCs across subtypes and stages of disease

A late-breaking presentation will showcase efficacy and safety outcomes from the DESTINY-Breast06 Phase III trial. In April, high-level results showed Enhertu demonstrated a statistically significant and clinically meaningful improvement in PFS versus standard-of-care chemotherapy in patients with HR-positive, HER2-low metastatic breast cancer. A clinically meaningful PFS improvement was also seen in patients with HER2-ultralow expression.

An oral presentation will spotlight data from an interim analysis of the dose-expansion phase of the DESTINY-Breast07 Phase Ib/II trial assessing Enhertu alone or in combination with pertuzumab as 1st-line treatment in HER2-positive metastatic breast cancer. These regimens are being further explored in the DESTINY-Breast09 Phase III clinical trial.

Additionally, a poster presentation will share updated OS and PFS results from the DESTINY-Breast03 Phase III trial of Enhertu versus trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer previously treated with trastuzumab and a taxane.

An oral presentation will feature patient-reported outcomes data from the TROPION-Breast01 Phase III trial of datopotamab deruxtecan in patients with inoperable or metastatic HR-positive, HER2-low or negative breast cancer previously treated with endocrine-based therapy and at least one systemic therapy. Previously presented primary results from TROPION-Breast01 showed datopotamab deruxtecan demonstrated a statistically significant and clinically meaningful improvement in PFS versus investigator’s choice of chemotherapy.

Two late-breaking presentations of results from the externally sponsored I-SPY2.2 Phase II trial will highlight the rates of pathologic complete response associated with neoadjuvant datopotamab deruxtecan, alone and in combination with Imfinzi, across breast cancer subtypes.

Advancing the next wave of medicines and combination therapies to attack cancer from multiple angles

A rapid oral presentation will spotlight safety and preliminary efficacy results from an investigator-initiated trial of C-CAR031, a novel autologous armoured Glypican 3 (GPC3) targeting chimeric antigen receptor T cell (CAR-T) therapy that is being investigated for hepatocellular carcinoma. The CAR-T is based on AZD5851, a novel cell therapy designed by AstraZeneca using their transforming growth factor-beta receptor II (TGFβRII) dominant negative armouring platform and is manufactured by AbelZeta Pharmaceuticals Inc. C-CAR031 is being developed in China under a co-development agreement between AbelZeta and AstraZeneca. AstraZeneca’s TGFβRII dominant negative armouring is designed to resist the immuno-suppressive tumour microenvironment and enhance the potential effectiveness of CAR-Ts in solid tumours.

A rapid abstract update will feature updated efficacy data from a Phase I trial of AZD0901, a potential first-in-class ADC targeting Claudin 18.2, which has shown promise as a therapeutic target in gastric cancer. First results were presented at the ASCO (Free ASCO Whitepaper) Plenary Series 2023.

Additionally, a clinical science symposium presentation of the externally sponsored CAPRI Phase II trial will share efficacy and safety results for ceralasertib, an ataxia telangiectasia and rad3-related (ATR) kinase inhibitor, plus Lynparza (olaparib) in patients with platinum-sensitive recurrent high-grade serous ovarian cancer.

Collaboration in the scientific community is critical to improving outcomes for patients. AstraZeneca is collaborating with Daiichi Sankyo Company Limited to develop and commercialise Enhertu and datopotamab deruxtecan, and with MSD (Merck & Co., Inc. in the US and Canada) to develop and commercialise Lynparza. AstraZeneca obtained full oncology rights to monalizumab from Innate Pharma in October 2018 through a co-development and commercialisation agreement initiated in 2015.

Key AstraZeneca presentations during ASCO (Free ASCO Whitepaper) 2024

Lead Author

Abstract Title

Presentation details (CDT)

Lung Cancers

Ramalingam, SS

Osimertinib (osi) after definitive chemoradiotherapy (CRT) in patients (pts) with unresectable stage (stg) III epidermal growth factor receptor-mutated (EGFRm) NSCLC: Primary results of the phase 3 LAURA study.

Abstract #LBA4

Plenary Session

2 June 2024

2:47pm

Spigel, DR

ADRIATIC: durvalumab (D) as consolidation treatment (tx) for patients (pts) with limited-stage small-cell lung cancer (LS-SCLC).

Abstract #LBA5

Plenary Session

2 June 2024

3:21pm

John, T

Molecular residual disease (MRD) analysis from the ADAURA trial of adjuvant (adj) osimertinib in patients (pts) with resected EGFR‑mutated (EGFRm) stage IB–IIIA non-small cell lung cancer (NSCLC).

Abstract #8005

Oral Abstract Session

3 June 2024

9:12am

Heymach, J

Outcomes with perioperative durvalumab (D) in pts with resectable NSCLC and baseline N2 lymph node involvement (N2 R-NSCLC): An exploratory subgroup analysis of AEGEAN.

Abstract #8011

Rapid Oral Abstract Session

2 June 2024

4:36pm

Aggarwal, C

Updated results from COAST, a phase 2 study of durvalumab (D) ± oleclumab (O) or monalizumab (M) in patients (pts) with stage III unresectable non-small cell lung cancer (uNSCLC).

Abstract #8046

Poster Session

3 June 2024

1:30pm

Levy, BP

Datopotamab deruxtecan (Dato-DXd) plus pembrolizumab (pembro) with or without platinum chemotherapy (Pt-CT) as first-line (1L) therapy for advanced non-small cell lung cancer (aNSCLC): Subgroup analysis from TROPION-Lung02.

Abstract #8617

Poster Session

3 June 2024

1:30pm

Janne, PA

Trastuzumab deruxtecan (T-DXd) in patients with HER2-mutant metastatic non–small cell lung cancer (mNSCLC): Final analysis results of DESTINY-Lung02.

Abstract #8543

Poster Session

3 June 2024

1:30pm

Sun, Y

Datopotamab deruxtecan (Dato-DXd) in Chinese patients (pts) with advanced or metastatic non-small cell lung cancer (NSCLC): Results from the phase 1/2 TROPION-PanTumor02 study.

Abstract #8548

Poster Session

3 June 2024

1:30pm

Lisberg, A

Intracranial efficacy of datopotamab deruxtecan (Dato-DXd) in patients (pts) with previously treated advanced/metastatic non-small cell lung cancer (a/m NSCLC) with actionable genomic alterations (AGA): Results from TROPION-Lung05.

Abstract #8593

Poster Session

3 June 2024

1:30pm

Sands, J

Analysis of drug-related interstitial lung disease (ILD) inpatients (pts) treated with datopotamab deruxtecan (Dato-DXd).

Abstract #8623

Poster Session

3 June 2024

1:30pm

Breast Cancers

Curigliano, G

Trastuzumab deruxtecan (T-DXd) vs physician’s choice of chemotherapy (TPC) in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-low or HER2-ultralow metastatic breast cancer (mBC) with prior endocrine therapy (ET): Primary results from DESTINY-Breast06 (DB-06).

Abstract #LBA1000

Oral Abstract Session

2 June 2024

7:30am

Pernas, S

Datopotamab deruxtecan (Dato-DXd) vs chemotherapy (CT) in previously treated inoperable or metastatic hormone receptor-positive, HER2-negative (HR+/HER2–) breast cancer (BC): Patient-reported outcomes (PROs) from the TROPION-Breast01 study.

Abstract #1006

Oral Abstract Session

1 June 2024

4:24pm

Andre, F

DESTINY-Breast07: Dose-expansion interim analysis of T-DXd monotherapy and T-DXd + pertuzumab in patients with previously untreated HER2+ mBC.

Abstract #1009

Oral Abstract Session

1 June 2024

5:24pm

Shatsky, RA

Rates of pathologic complete response (pCR) after datopotamab deruxtecan (Dato) plus durvalumab (Durva) in the neoadjuvant setting: Results from the I-SPY2.2 trial.

Abstract #LBA501

Oral Abstract Session

3 June 2024

3:12pm

Meisel, J

Rates of pathologic complete response (pCR) after neoadjuvant datopotamab deruxtecan (Dato): Results from the I-SPY2.2 trial.

Abstract #LBA509

Rapid Oral Abstract Session

31 May 2024

2:45pm

Hamilton, EP

Trastuzumab deruxtecan (T-DXd) vs trastuzumab emtansine (T-DM1) in patients (pts) with HER2+ metastatic breast cancer (mBC): Updated survival results of DESTINY-Breast03.

Abstract #1025

Poster Session

2 June 2024

9:00am

Gastrointestinal Cancers

Zhang, Q

Phase I study of C-CAR031, a GPC3-specific TGFβRIIDN armored autologous CAR-T, in patients with advanced hepatocellular carcinoma (HCC).

Abstract #4019

Rapid Oral Abstract Session

3 June 2024

10:51am

Xu, RH

Updates on Abstract 434420: A Phase 1 Trial of Claudin 18.2-Specific Antibody-Drug Conjugate CMG901 in Patients with Advanced Gastric/Gastroesophageal Junction Cancer

Education Session

1 June 2024

12:42pm

Chan, SL

Safety analysis by treatment periods from EMERALD-1: A phase 3, randomized, placebo-controlled study of transarterial chemoembolization with durvalumab with/without bevacizumab in participants with embolization-eligible unresectable hepatocellular carcinoma.

Abstract #4122

Poster Session

1 June 2024

1:30pm

Kelley, RK

T cell receptor and immune gene expression pharmacodynamics for durvalumab monotherapy and in combination with tremelimumab or bevacizumab in unresectable hepatocellular carcinoma (uHCC).

Abstract #4022

Poster Session

1 June 2024

1:30pm

Hamilton, A

ATHENA: A phase 1/2 study of AZD5851, a chimeric antigen receptor (CAR) T-cell therapy directed against GPC3 in adult patients with advanced/recurrent hepatocellular carcinoma (HCC).

Abstract #TPS2675

Poster Session

1 June 2024

9:00am

Shen, L

GEMINI-Gastric: A phase 2 study of novel treatment combinations in patients with locally advanced unresectable or metastatic gastric cancers.

Abstract #TPS4182

Poster Session

1 June 2024

1:30pm

Zhou, J

GEMINI-Hepatobiliary: A phase 2 study of novel first-line immuno-oncology-based treatments in patients with advanced hepatobiliary cancers.

Abstract #TPS4187

Poster Session

1 June 2024

1:30pm

Gynaecological Cancers

Simpkins, F

Combination ATR and PARP Inhibitor (CAPRI): A phase 2 study of ceralasertib plus olaparib in patients with recurrent, platinum-sensitive epithelial ovarian cancer (cohort A).

Abstract #5510

Clinical Science Symposium

1 June 2024

1:39pm

Pan-Tumour

Raufi, AG

CLARITY-PanTumor01: A phase 2 trial of the claudin 18.2-specific antibody-drug conjugate AZD0901 (CMG901) in patients with CLDN18.2-expressing advanced solid tumors.

Abstract #TPS3163

Poster Session

1 June 2024

9:00am

Punekar, SR

An open-label, phase 1, multicenter study to evaluate the safety and preliminary anti-tumor activity of NT‑112 in human leukocyte antigen-C*08:02–positive adult patients with unresectable, advanced, and/or metastatic solid tumors that are positive for the KRAS G12D mutation.

Abstract #TPS2677

Poster Session

1 June 2024

9:00am

Spira, AI

PRIMROSE: A modular phase 1/2a study of AZD3470, an MTA-cooperative PRMT5 inhibitor, in patients with MTAP deficient advanced solid tumors.

Abstract #TPS3179e

Poster Session

1 June 2024

9:00am

Perez, A

Non-clinical evaluation of NT-175, an autologous T cell product engineered to express an HLA-A*02:01-restricted TCR targeting TP53 R175H and resistant to TGF-b inhibition.

Abstract #2560

Poster Session

1 June 2024

9:00am