Pfizer joins the Parp party


Approval for Pfizer’s talazoparib – now branded Talzenna – marks the second breast cancer approval for a Parp inhibitor. Lynparza, jointly marketed by Astrazeneca and Merck & Co, won a green light in largely the same late-stage, metastatic setting in January. These patients have BRCA-mutated, Her2-negative disease, and most will have already received various chemotherapies or other targeted agents. Neither Talzenna nor Lynparza managed to show a survival benefit, though both extended progression-free survival by around three months, which was statistically significant. Hazard ratios of 46% and 42% respectively illustrate how closely matched the Parp inhibitors are deemed to be. Tolerability is more of a differentiator, and Talzenna’s label flags higher rates of anaemia and neutropenia than others in the class. This makes the compound look more like Tesaro’s Zejula, which is associated with thrombocytopenia. The sellside estimates that Lynparza will generate sales of $753m by 2024 in breast cancer, and Pfizer will have to work hard to catch up with the incumbent. Astra and Merck have established a very strong position in the Parp space over the past few years, though they have yet to come up against a rival with similarly deep pockets.

Outlook for the Parp space
    Annual sales ($m)  
Product Company 2018e 2021e 2024e Notes
Lynparza Astra/Merck & Co 611 1,345 2,238 Approved in US for 2L maintenance and 3L ovarian cancer, and BRCA-mutated, Her2-neg metastatic breast cancer, post chemo. 
Zejula Tesaro 228 837 1,568 Approved in US for 2L maintenance, ovarian cancer. 
Rubraca Clovis  130 720 1,199 Approved in US for 2L maintenance and 3L ovarian cancer.
Talzenna Pfizer 1 313 609 Approved in US for BRCA-mutated, Her2-neg locally advanced or metastatic breast cancer.
Pamiparib Beigene - 57 303 Two phase III trials ongoing in gastric cancer and ovarian (China only).
Veliparib Abbvie - 93 191 Two phase III failures in TNBC and squamous NSCLC; pivotal trials in breast, lung and ovarian ongoing. 
Total market 971 3,364 6,107  
TNBC = triple-negative breast cancer; NSCLC = non-small cell lung cancer. Source: EvaluatePharma.

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