
SABCS 2019 – Macrogenics finds some better Herceptins are better than others
Data from the Sophia trial of Macrogenics’ margetuximab, presented at the San Antonio Breast Cancer Symposium today, underline what was already fairly clear: of the anti-Her2 projects intended to be a “better Herceptin”, Astrazeneca and Daiichi Sankyo’s antibody-drug conjugate, trastuzumab deruxtecan, is way out ahead. Margetuximab could show no overall survival advantage over Herceptin at the second interim analysis of Sophia data, with a median OS of 21.6 months versus 19.8 months for Roche’s drug. The final pre-specified OS analysis of Sophia is expected in the second half of 2020, by which time trastuzumab deruxtecan will almost certainly be approved in the third-line setting. The table below summarises data from various studies conducted in late-line breast cancer patients, and while such a comparison is imperfect it clearly shows trastuzumab deruxtecan trouncing the others. It also shows that the sellside has made up its mind in terms of which horse to back.
Cross-trial comparison of anti-Her agents | ||||||
---|---|---|---|---|---|---|
Company | Agent | Trial | ORR | Median PFS (months) | Median DoR (months) | 2024e WW sales |
Astrazeneca/ Daiichi |
Trastuzumab deruxtecan | Destiny | 60.9% | 16.4 | 14.8 | $2bn |
Roche | Kadcyla | Emilia | 43.6% | 9.6 | - | $1.9bn |
Macrogenics | Margetuximab | Sophia | 22.1% | 5.8 | 6 | $293m |
Puma | Nerlynx | Nala | 32.8% | 8.8 | 8.5 | $283m |
Seattle Genetics | Tucatinib | Her2Climb | 40.6% | 7.8 | - | $268m |
ORR=objective response rate. PFS=progression-free survival. DoR=duration of response. Source: EvaluatePharma; NEJM; company statements; SABCS. |