AstraZeneca’s Immuno-Oncology Advancements in Bladder and Liver Cancer Show Promising Long-Term Survival Benefits
November 8, 2024 – In a recent episode of the Pharmaceutical Executive podcast, Shubh Goel, head of immuno-oncology, gastrointestinal tumors at AstraZeneca’s US oncology business unit, shed light on the company’s latest advancements in cancer treatment, focusing on the promising results observed in bladder and liver cancer clinical trials. The discussion centered around the NIAGARA trial in bladder cancer and the impressive five-year overall survival data from the HIMALAYA trial, specifically highlighting the sustained efficacy of the STRIDE regimen (durvalumab plus tremelimumab) in patients with unresectable liver cancer.
Goel emphasized the significance of the NIAGARA trial, which evaluated a novel immunotherapy-based combination regimen in patients with muscle-invasive bladder cancer. While detailed results are yet to be fully disclosed, Goel’s comments suggest the trial is yielding encouraging data, potentially offering new treatment avenues for this challenging cancer type. The NIAGARA trial adds to AstraZeneca’s growing portfolio of bladder cancer research, reinforcing their commitment to developing innovative therapies. He highlighted the growing understanding of the tumor microenvironment’s role in bladder cancer progression and how targeted therapies, especially immunotherapies, hold potential to change the treatment landscape for these patients. Goel emphasized the importance of identifying predictive biomarkers that can help personalize treatment approaches and optimize outcomes.
The podcast also dedicated a significant portion to the groundbreaking HIMALAYA trial, a Phase III study that evaluated the STRIDE regimen, a combination of durvalumab (an anti-PD-L1 antibody) and tremelimumab (an anti-CTLA-4 antibody), in patients with unresectable hepatocellular carcinoma (HCC), the most common type of liver cancer. The five-year overall survival data from HIMALAYA, presented earlier this year, garnered significant attention within the oncology community. These data demonstrated a sustained survival benefit with the STRIDE regimen compared to the standard-of-care treatment, sorafenib, solidifying its position as a potential game-changer in the treatment paradigm for unresectable HCC.
Goel elaborated on the mechanism of action of the STRIDE regimen, explaining how the combination of durvalumab and tremelimumab works synergistically to enhance the body’s immune response against cancer cells. Durvalumab blocks the PD-L1 protein, which normally inhibits T-cell activation, while tremelimumab targets the CTLA-4 receptor, another immune checkpoint that suppresses anti-tumor immunity. By simultaneously targeting these two checkpoints, the STRIDE regimen unleashes a more potent and sustained immune response, leading to improved tumor control and ultimately, longer survival in patients with unresectable HCC, a patient population with historically limited treatment options. The long-term follow-up data from HIMALAYA, according to Goel, provides compelling evidence of the durable clinical benefit of this immunotherapy combination.
The sustained efficacy observed in the HIMALAYA trial holds profound implications for patients with unresectable HCC, a population often facing a grim prognosis. Historically, treatment options for this patient population have been limited, with systemic chemotherapy offering modest survival benefits. The arrival of targeted therapies like sorafenib marked a significant advancement, but the five-year overall survival rates remained relatively low. The STRIDE regimen, with its demonstrated ability to provide long-term survival benefits, represents a paradigm shift in the treatment of unresectable HCC. Goel highlighted the impact of these findings on clinical practice, noting that the STRIDE regimen is rapidly becoming a preferred first-line treatment option for eligible patients, offering them hope for a longer and more fulfilling life.
Goel further elaborated on the importance of ongoing research efforts to further refine the use of immunotherapy in liver cancer. He discussed the potential for combining the STRIDE regimen with other therapeutic modalities, such as targeted therapies or locoregional treatments, to further enhance its efficacy. He also emphasized the importance of identifying biomarkers that can predict which patients are most likely to benefit from immunotherapy, allowing for a more personalized and precise approach to treatment. AstraZeneca is committed to leading these research endeavors and bringing further innovative treatments to patients with liver cancer, underlined Goel, showcasing the company’s dedication to advancing the field of immuno-oncology. He also stressed the importance of collaborations within the scientific community to accelerate progress and ensure that patients have access to the latest advancements in cancer care.