J&J’s Rybrevant Beats Chemo In Lung Cancer Patients Who Failed Tagrisso

Johnson & Johnson, Rybrevant, EGFR mutated NSCLC, Tagrisso, Osimirtinib, Clinical trial results, AstraZeneca

The medical community buzzed with anticipation when Johnson & Johnson (J&J) released information about Rybrevant, their latest drug venture into the vast realm of non-small cell lung cancer (NSCLC) treatments. While originally greenlit for a more niche subset of NSCLC, fresh data suggests it might be gearing up to challenge AstraZeneca’s reigning champ, Tagrisso, in a much larger market space.

Rybrevant’s recent strides come to light as J&J unveiled that two combination treatments of the drug significantly outperformed chemotherapy in halting disease progression or death for EGFR-mutant NSCLC patients. These patients had previously given Tagrisso a go. The results? “Statistically significant and clinically meaningful” betterment in halting the disease’s progression, according to J&J.

Diving deeper, the MARIPOSA-2 trial’s outcome proved especially promising, meeting both its primary objectives. Specifically, the trial catered to patients whose NSCLC conditions were linked with EGFR exon 19 deletions or exon 21 L858R substitution. These mutations are major players, accounting for around 85% of all EGFR mutations. In contrast, the Rybrevant-approved exon 20 mutation is found in fewer than 10% of EGFR NSCLC instances. This suggests that the real game for Rybrevant could be its potential to penetrate the dominant exon 19 and 21 segment.

Adding another layer to the story, Lazertinib, J&J’s partner in crime in this venture, isn’t new to the scene. First welcomed in Korea in 2021, Lazertinib treats patients with the EGFR T790M mutation-positive NSCLC, mirroring the initial 2015 FDA approval of Tagrisso.

However, it’s essential not to get lost in the immediate applause. While MARIPOSA-2’s results are undoubtedly a breakthrough, the trial represents just a tiny ripple in J&J’s anticipated mammoth $5 billion sales splash for the Rybrevant-Lazertinib duo. All eyes are now keenly set on the MARIPOSA trial’s forthcoming results.

It’s a high-stakes showdown. The MARIPOSA trial, which will compare the Rybrevant-Lazertinib pairing against Tagrisso—a drug that raked in a whopping $5.4 billion in 2022—promises a captivating tug-of-war. Tagrisso’s trustworthiness as the go-to first-line care means J&J has its work cut out. Evidence of Rybrevant halting the disease isn’t enough; doctors will be seeking strong proof of enhanced overall survival rates.

And the plot thickens. With AstraZeneca recently boasting phase 3 success combining Tagrisso with chemotherapy, Tagrisso monotherapy might be facing a shakeup as the benchmark. Keep your eyes peeled for more at the upcoming 2023 World Conference on Lung Cancer, where the nitty-gritty from this FLAURA2 study will be unveiled.

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