At the forefront of lung cancer treatment
Lung cancer is the most common form of cancer worldwide, with approximately 1.8 million cases diagnosed and 1.69 million deaths each year1,2. Only 16% of patients are diagnosed when the tumour is still localised to the lung and for those patients diagnosed at a later stage, the prognosis is especially poor3,4. As such, AstraZeneca is prioritising lung cancer research to address the significant unmet need for treatments at every stage of the disease continuum. Our focus is primarily on non-small cell lung cancer (NSCLC), which accounts for 80 to 85 percent of all lung cancer cases globally. We also have ongoing research in small cell lung cancer (SCLC), an area of high unmet need, which makes up the remaining 15 to 20 percent of cases5.
AstraZeneca has a portfolio of approved and potential new medicines in late-stage clinical development for the treatment of NSCLC across all stages of disease and lines of therapy. Our approach is focused on using ground-breaking science to further our understanding of lung cancer by identifying biomarkers which provide actionable targets for the development of precision medicines. Biomarkers are biological molecules found in body fluids or tissues that provide insight into the state of the disease, such as gene mutations or protein expressions, and are integral to understanding its biology.
Targeting Tumour Drivers
AstraZeneca is focusing our lung cancer research and development efforts on discovering and targeting the genetic drivers and resistance mechanisms of cancer. By identifying the mechanisms through which tumour cells grow and proliferate, we can develop drugs that target these molecules, and this has been driving our work in NSCLC for nearly thirty years6. Since then, our research teams have accelerated the understanding of key molecular mutations in a broad range of cancers, and the use of specific genetic mutations as biomarkers has enabled us to develop precision therapies for specific subgroups of lung cancer patients with significant treatment needs.
Our research has led us to address the unmet needs of patients with mutations in the epidermal growth factor receptor (EGFR), which occur in 10-15% of NSCLC patients in the US and EU5,7,8, and 30-40% of NSCLC patients in Asia9. For those patients that we cannot serve with EGFR-targeted therapies, our extensive late-stage Immuno-Oncology programme may provide clinical benefit.
Boosting the Immune Response to Cancer
As we're continuing to advance science for NSCLC patients with an identifiable driver mutation, we are simultaneously driving towards a new era with our lmmuno-Oncology pipeline. AstraZeneca's investigational lmmuno-Oncology therapies have been designed to target immune checkpoints, that are exploited by cancer to avoid or suppress the immune system’s ability to recognise and destroy tumour cells.
Pioneers in Precision Medicine
lntegral to matching patients to the right treatment at the right time, is the development of companion diagnostics. Quality of testing is paramount to treatment decision-making for optimal patient outcomes, and testing is critical at every stage of the disease continuum. Alongside our innovative therapies, we are collaborating to deliver a range of diagnostic technologies to assess disease at all stages and ensure development of optimally-targeted therapies.
AstraZeneca partnered to launch the first tissue-based diagnostic and the first plasma-based (ctDNA) diagnostic to identify of EGFR mutations in NSCLC, both of which are used extensively in clinical practice. We are also focused on the development of assays to identify patients eligible for treatment with our Immuno-Oncology medicines, and ensuring that those already on the market are delivering the best value through our practice-changing concordance research.
1. World Health Organization. Cancer Fact Sheet. Available at http://www.who.int/mediacentre/factsheets/fs297/en/. Accessed June 2017.
2. World Cancer Research Fund. Lung cancer – the most common cancer in the world. Available at http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/lung-cancer-statistics. Accessed June 2017.
3. Shepherd FA. et al. Lung cancer in 2013: state of the art therapy for metastatic disease. Am Soc Clin Oncol Educ Book. 2013; 339-46
4. American Lung Association: Lung cancer fact sheet. Available at: http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html. Accessed May 2017.
5. Felip E, Vilar E. The expanding role of systemic treatment in non-small cell lung cancer neo-adjuvant therapy. Ann Oncol. 2006; 17(Suppl 10):x108-12.
6. Hendler F J, Ozanne BW. Human squamous cell lung cancers express increased epidermal growth factor receptors. The Journal of Clinical Investigation. 1984 Aug; 74(2) 647-651
7. Szumera-Ciećkiewicz A, et al. EGFR mutation testing on cytological and histological samples in non-small cell lung cancer: a Polish, single institution study and systematic review of European incidence. Int J Clin Exp Path9ol. 2013; 6(12):2800-12
8. Keedu VL. et al. American Society of Clinical Oncology provisional clinical opinion: epidermal growth factor receptor (EGFR) Mutation testing for patients with advanced non-small cell lung cancer considering first-line EGFR tyrosine kinase inhibitor therapy. J Clin Oncol. 2011; 29: 2121-7
9. Ellison G. et al. EGFR mutation testing in lung cancer: a review of available methods and their use for analysis of tumour tissue and cytology samples. J Clin Pathol. 2013; 66:79-89