Tecentriq label gives Roche its best shot in first-line lung cancer

Tecentriq has got the broad US label Roche was hoping for in first-line non-small cell lung cancer, maximising its chances of taking on Merck & Co’s Keytruda in the biggest prize of immuno-oncology. In combination with chemotherapy and Avastin, Tecentriq was approved by the FDA for use in first-line non-metastatic disease in patients with no EGFR or ALK mutations. The commercial battle will come down to Keytruda’s incumbent position as the first PD-(L)1 to be used in a first-line chemo combo; the two drugs' safety profiles; and perceptions of efficacy, the latter disadvantaging the Tecentriq combination. The use of a second costly monoclonal antibody in the form of Avastin, which has not been clearly shown to add anything to the efficacy profile, will also affect uptake of the Roche combo.