Merck and Eisai announced that phase III studies in lung cancer (NSCLC) evaluating the combination of pembrolizumab (Keytruda) and lenvatinib (VEGF TKI) failed to meet their primary endpoints

Immagine News

Merck and Eisai announced that two NSCLC P3 studies evaluating the combination of pembrolizumab (Keytruda) and lenvatinib (VEGF TKI) failed to meet their primary endpoints:

  • LEAP-006, evaluating pembro + lenvatinib + chemo vs. pembro + chemo in 1L non-squamous NSCLC, failed to meet its coprimary OS & PFS endpoints, as well as its secondary ORR endpoint

  • LEAP-008, evaluating pembro + lenvatinib vs. docetaxel in 2L+ (prior platinum-chemo and IO-experienced) NSCLC failed to meet its coprimary OS & PFS endpoints, as well as its secondary ORR endpoint

The failure of these studies removes this combination as a competitor in 1L NSCLC and in 2L+ NSCLC, also considering the recent failures of pembro + lenvatinib in other indications and the toxicity of this regimen.

Key Takeaways/Potential Implications

  • LEAP-008 was the final P3 study of the IO + TKI class of regimens, and follows previous failures from BMS/Mirati (nivolumab + sitravatinib) and Roche/Exelixis (atezolizumab + cabozantinib)
  • Datopotamab deruxtecan (dato-dxd; TROP2 ADC) in 2L+ NSCLC: the P3 TROPION-Lung01 study was previously announced as positive for PFS in July 2023, with a not-yet-significant trend in OS. Like 2L+ NSCLC, dato-dxd remains the largest competitive threat in 1L NSCLC
    • For domvanalimab, TIGIT regimens from Merck and Roche remain the largest threat, with PFS data from Merck’s P3 KEYVIBE-007 study of pembro/vibostolimab + chemo potentially expected in H1’24

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