Physician Views: Gauging expectations for Imfinzi in Stage III NSCLC

Following its approval by the FDA late last week, can AstraZeneca's Imfinzi rapidly secure adoption as a treatment for unresectable Stage III non-small-cell lung cancer (NSCLC) before competitors gain similar labels two to three years from now? Or will other products in the PD-(L)1 class be used off-label in this setting?

We are snap-polling US oncologists to get a better idea, with the following questions…

The FDA approved Imfinzi (durvalumab) for the treatment of patients with unresectable Stage III NSCLC whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (CRT). Approval is based on positive progression-free survival (PFS) data from the Phase III PACIFIC trial, in which Imfinzi demonstrated an improvement in median PFS of 11.2 months versus placebo - representing a 48 percent reduction in relative risk of progression or death - regardless of PD-L1 status.

Have you already used Imfinzi (or an alternative PD-1 or PD-L1 inhibitor) in this setting on an 'off label' basis?

No

Yes - Imfinzi

Yes - other PD-1/PD-L1

Based on available data, how quickly do you think Imfinzi will be adopted as a treatment for Stage III NSCLC patients whose disease has not progressed following concurrent platinum-based CRT?

None

Slowly

Moderately

Quickly

Very quickly

Do you expect alternative PD-1 and/or PD-L1 inhibitors to be routinely used instead of Imfinzi for the treatment of unresectable Stage III NSCLC (despite Imfinzi being the only drug in class approved - or indeed studied in a Phase III trial - for this indication)?

No

Yes

Is PFS data from PACIFIC definitively practice changing? (The PACIFIC trial is ongoing to evaluate overall survival [OS] data in unresectable Stage III NSCLC)

Yes

No - need positive overall survival data

In 12 months' time, what percentage of eligible patients with unresectable Stage III NSCLC (i.e. those whose disease has not progressed following concurrent platinum-based CRT) would you anticipate treating with Imfinzi?

Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by Medefield MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at info@firstwordpharma.com.

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