Roche’s Itovebi demonstrated statistically significant and
clinically meaningful overall survival benefit in a certain type of
HR-positive advanced breast cancer
- Updated overall survival (OS) results - a key secondary
endpoint - reinforce the significant benefit of the
ItovebiTM
(inavolisib)-based regimen for patients with
advanced PIK3CA-mutated,
HR-positive, HER2-negative breast cancer in the first-line
setting
- Primary analysis showed the Itovebi-based regimen
reached statistical significance, more than doubling
progression-free survival in this patient
population1
- Full OS results from the phase III INAVO120 study will
be presented at an upcoming medical meeting
Basel, 28 January 2025 - Roche (SIX: RO, ROG; OTCQX: RHHBY)
announced today positive topline results from the overall survival
(OS) analysis of the phase III INAVO120 study investigating
ItovebiTM (inavolisib) in combination with palbociclib
(Ibrance®) and fulvestrant for people with PIK3CA-mutated,
hormone receptor (HR)-positive, human epidermal growth factor
receptor 2 (HER2)-negative, endocrine-resistant, locally advanced
or metastatic breast cancer. The study met its key secondary
endpoint, showing a statistically significant and clinically
meaningful OS benefit with the Itovebi-based regimen compared with
palbociclib and fulvestrant alone.
"The INAVO120 overall survival results show that the
Itovebi-based regimen not only delayed disease progression, but
also helped people with advanced HR-positive,
PIK3CA-mutated breast cancer live longer,” said Levi
Garraway, M.D., Ph.D., Roche’s Chief Medical Officer and Head of
Global Product Development. “These findings underscore our ambition
to improve survival rates for people with breast cancer. The
Itovebi-based regimen has the potential to become the new standard
of care for these patients.”
These OS results build upon the previously reported primary
analysis, which showed that the Itovebi-based regimen reduced the
risk of disease worsening or death by 57% compared with palbociclib
and fulvestrant alone (15.0 months vs. 7.3 months; hazard ratio
[HR]=0.43, 95% CI: 0.32-0.59, p<0.001) in the first-line
setting.1 OS data were immature at the time of primary
analysis, but a clear positive trend was observed at that time
(stratified HR=0.64, 95% CI: 0.43-0.97, p=0.0338 (boundary of
0.0098)).1 No new safety signals were observed since the
previous analysis. The full results from the OS analysis will be
presented at an upcoming medical meeting.
The U.S. Food and Drug Administration (FDA) approved the
Itovebi-based regimen in October 2024 for the treatment of adults
with endocrine-resistant, PIK3CA-mutated, HR-positive,
HER2-negative, locally advanced or metastatic breast cancer, as
detected by an FDA-approved test, following recurrence on or after
completing adjuvant endocrine therapy.2 Data from
INAVO120, recently published in the New England Journal of
Medicine, are also being reviewed by other global health
authorities, including the European Medicines Agency.
Itovebi is currently being investigated in four
company-sponsored phase III clinical studies (INAVO120, INAVO121,
INAVO122, INAVO123) in PIK3CA-mutated locally advanced or
metastatic breast cancer in various combinations.3-6 We
are exploring additional studies in breast cancer and other tumour
types with the hope of bringing the benefit of this targeted
therapy to more people with PIK3CA-mutated cancer and
addressing patient unmet needs.
About Itovebi TM
(inavolisib)
Itovebi is an oral, targeted treatment with best-in-class potential
that could provide well-tolerated, durable disease control and
potentially improved outcomes for people with
PIK3CA-mutated, hormone receptor (HR)-positive, human
epidermal growth factor receptor 2 (HER2)-negative, locally
advanced or metastatic breast cancer, who often have a poor
prognosis and are in urgent need of new treatment
options.1,7,8 Itovebi has been designed to help minimise
the overall burden and toxicity of treatment and is differentiated
from other PI3K inhibitors due to its high potency and specificity
for the PI3K alpha isoform versus other isoforms, and unique
mechanism of action that facilitates the degradation of mutated
PI3K alpha.9,10
About the INAVO120 study
The INAVO120 study [NCT04191499] is a phase III, randomised,
double-blind, placebo-controlled study evaluating the efficacy and
safety of Itovebi™ (inavolisib) in combination with palbociclib and
fulvestrant versus placebo plus palbociclib and fulvestrant in
people with PIK3CA-mutated, hormone receptor
(HR)-positive, human epidermal growth factor receptor 2
(HER2)-negative, locally advanced or metastatic breast cancer whose
disease progressed during treatment or within 12 months of
completing adjuvant endocrine therapy and who have not received
prior systemic therapy for metastatic disease.3
The study included 325 patients, who were randomly assigned to
either the investigational or control treatment arm.3
The primary endpoint is progression-free survival, as assessed by
investigators, defined as the time from randomisation in the
clinical trial to the time when the disease progresses, or a
patient dies from any cause.3 Secondary endpoints
include overall survival, objective response rate, and clinical
benefit rate.3
Beyond INAVO120, Itovebi is currently being investigated in
three additional company-sponsored phase III clinical studies in
PIK3CA-mutated locally advanced or metastatic breast
cancer in various combinations:4,5,6
- in combination with fulvestrant versus alpelisib plus
fulvestrant in HR-positive/HER2-negative breast cancer post
cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and endocrine
combination therapy (INAVO121; NCT05646862).
- in combination with pertuzumab plus trastuzumab for
subcutaneous injection (SC) versus pertuzumab plus trastuzumab for
SC and optional physician's choice of endocrine therapy as a
maintenance treatment in HER2-positive disease (INAVO122;
NCT05894239).
- in combination with CDK4/6i and letrozole versus placebo plus a
CDK4/6i and letrozole in the first-line setting in
endocrine-sensitive, PIK3CA-mutated
HR-positive/HER2-negative breast cancer (INAVO123;
NCT06790693).
About hormone receptor (HR)-positive breast
cancer
HR-positive breast cancer is the most prevalent type of all breast
cancers, accounting for approximately 70% of cases.11,12
A defining feature of HR-positive breast cancer is that its tumour
cells have receptors that attach to one or both hormones –
oestrogen or progesterone – which can contribute to tumour growth.
People diagnosed with HR-positive metastatic breast cancer often
face the risk of disease progression and treatment side effects,
creating a need for additional treatment options.12-14
The PI3K signalling pathway is commonly dysregulated in HR-positive
breast cancer, often due to activating PIK3CA mutations,
which have been identified as a potential mechanism of intrinsic
resistance to standard of care endocrine therapy in combination
with cyclin-dependent kinase 4/6 inhibitors.8
About Roche in breast cancer
Roche has been advancing breast cancer research for more than 30
years with the goal of helping as many people with the disease as
possible. Our medicines, along with companion diagnostic tests,
have contributed to bringing breakthrough outcomes in human
epidermal growth factor 2-positive and triple-negative breast
cancers. As our understanding of breast cancer biology rapidly
improves, we are working to identify new biomarkers and approaches
to treatment for other subtypes of the disease, including oestrogen
receptor-positive breast cancer, which is a form of hormone
receptor-positive breast cancer, the most prevalent type of all
breast cancers.11,12
About Roche
Founded in 1896 in Basel, Switzerland, as one of the first
industrial manufacturers of branded medicines, Roche has grown into
the world’s largest biotechnology company and the global leader in
in-vitro diagnostics. The company pursues scientific excellence to
discover and develop medicines and diagnostics for improving and
saving the lives of people around the world. We are a pioneer in
personalised healthcare and want to further transform how
healthcare is delivered to have an even greater impact. To provide
the best care for each person we partner with many stakeholders and
combine our strengths in Diagnostics and Pharma with data insights
from the clinical practice.
For over 125 years, sustainability has been an integral part of
Roche’s business. As a science-driven company, our greatest
contribution to society is developing innovative medicines and
diagnostics that help people live healthier lives. Roche is
committed to the Science Based Targets initiative and the
Sustainable Markets Initiative to achieve net zero by 2045.
Genentech, in the United States, is a wholly owned member of the
Roche Group. Roche is the majority shareholder in Chugai
Pharmaceutical, Japan.
For more information, please visit www.roche.com.
All trademarks used or mentioned in this release are protected
by law.
References
[1] Turner NC, et al. Inavolisib-Based Therapy in PIK3CA-Mutated
Advanced Breast Cancer. NEJM. 2024;391(17):1584-96.
[2] Roche. FDA approves Roche’s Itovebi, a targeted treatment for
advanced hormone receptor-positive, HER2-negative breast cancer
with a PIK3CA mutation [Internet; cited 2025 January].
Available from:
https://www.roche.com/investors/updates/inv-update-2024-10-11b.
[3] ClinicalTrials.gov. A Study Evaluating the Efficacy and Safety
of Inavolisib + Palbociclib + Fulvestrant vs Placebo + Palbociclib
+ Fulvestrant in Patients With PIK3CA-Mutant, Hormone
Receptor-Positive, Her2-Negative, Locally Advanced or Metastatic
Breast Cancer (INAVO120) [Internet; cited 2025 January]. Available
from: https://classic.clinicaltrials.gov/ct2/show/NCT04191499.
[4] ClinicalTrials.gov. A Study Evaluating the Efficacy and Safety
of Inavolisib Plus Fulvestrant Compared With Alpelisib Plus
Fulvestrant in Participants With HR-Positive, HER2-Negative,
PIK3CA Mutated, Locally Advanced or Metastatic Breast
Cancer Post CDK4/6i and Endocrine Combination Therapy (INAVO121)
[Internet; cited 2025 January]. Available from:
https://classic.clinicaltrials.gov/ct2/show/NCT05646862.
[5] ClinicalTrials.gov. A Study to Evaluate the Efficacy and Safety
of Inavolisib in Combination With Phesgo Versus Placebo in
Combination With Phesgo in Participants With
PIK3CA-Mutated HER2-Positive Locally Advanced or
Metastatic Breast Cancer [Internet; cited 2025 January]. Available
from: https://classic.clinicaltrials.gov/ct2/show/NCT05894239.
[6] ClinicalTrials.gov. A Study Evaluating the Efficacy and Safety
of Inavolisib Plus CDK4/6 Inhibitor and Letrozole vs Placebo +
CDK4/6i and Letrozole in Participants With Endocrine-Sensitive
PIK3CA-Mutated, Hormone Receptor-Positive, HER2-Negative Advanced
Breast Cancer (INAVO123) [Internet; cited 2025 January]. Available
from: https://clinicaltrials.gov/study/NCT06790693.
[7] Fillbrunn M, et al. PIK3CA mutation status, progression and
survival in advanced HR+/HER2- breast cancer: a meta-analysis of
published clinical trials. BMC Cancer. 2022;22:1002.
[8] Anderson E, et al. A Systematic Review of the Prevalence and
Diagnostic Workup of PIK3CA Mutations in HR+/HER2– Metastatic
Breast Cancer. Int J Breast Cancer. 2020;2020:3759179.
[9] Juric D, et al. A phase I/Ib study of inavolisib (GDC-0077) in
combination with fulvestrant in patients (pts) with PIK3CA-mutated
hormone receptor-positive/HER2-negative (HR+/HER2–) metastatic
breast cancer. Presented at San Antonio Breast Cancer Symposium,
2020 December 7-10; San Antonio, USA. Abstract #P5-17-05.
[10] Hong R, et al. GDC-0077 is a selective PI3K alpha inhibitor
that demonstrates robust efficacy in PIK3CA mutant breast cancer
models as a single agent and in combination with standard of care
therapies. Cancer Res. 2018;78(4):4-14.
[11] National Cancer Institute: Surveillance, Epidemiology and Ends
Result Program. Cancer Stat Facts: Female Breast Cancer Subtypes
[Internet; cited 2025 January]. Available from:
https://seer.cancer.gov/statfacts/html/breast-subtypes.html.
[12] Lim E, et al. The natural history of hormone receptor-positive
breast cancer. Oncology (Williston Park).
2012;26(8):688-94,696.
[13] Tomas R and Barrios CH. Optimal management of hormone receptor
positive metastatic breast cancer in 2016. Ther Adv Med Oncol.
2015;7(6):304-20.
[14] Galipeau N, et al. Understanding key symptoms, side effects,
and impacts of HR+/HER- advanced breast cancer: qualitative study
findings. J Patient-Rep Outcomes. 2019;3(1):10.
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