AstraZeneca announced positive results from the TOPAZ-1 Phase III trial showed AstraZeneca's IMFINZI® (durvalumab) in combination with standard-of-care chemotherapy, demonstrated a statistically significant and clinically meaningful improvement in overall survival (OS) and progression-free survival (PFS) versus chemotherapy alone as a first-line treatment for patients with advanced biliary tract cancer (BTC). These results will be presented on January 21, 2022 at the 2022 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium. In a predefined interim analysis, patients treated with IMFINZI in combination with standard-of-care chemotherapy experienced a 20% reduction in the risk of death versus chemotherapy alone (based on a hazard ratio [HR] of 0.80; 95% confidence interval [CI], 0.66-0.97; 2-sided p=0.021).

Median OS was 12.8 months versus 11.5 for chemotherapy. An estimated 25% of patients were still alive at two years versus 10% for chemotherapy. Results also showed a 25% reduction in the risk of disease progression or death with IMFINZI plus chemotherapy (HR, 0.75; 95% CI, 0.64-0.89; 2-sided p=0.001).

Median PFS was 7.2 months for the combination versus 5.7 for chemotherapy. Patients treated with IMFINZI plus chemotherapy achieved an objective response rate (ORR) of 26.7% versus an ORR of 18.7% for patients treated with chemotherapy alone. IMFINZI plus chemotherapy did not increase the discontinuation rate due to adverse events (AEs) compared to chemotherapy alone.

Grade 3 or 4 treatment-related AEs were experienced by 62.7% of patients treated with IMFINZI and chemotherapy, and by 64.9% of patients receiving chemotherapy alone. Treatment-related AEs led to discontinuation in 8.9% of patients treated with the IMFINZI combination versus 11.4% of patients receiving chemotherapy. In December 2020, IMFINZI was granted Orphan Drug Designation in the US for the treatment of BTC.

In October 2021, an Independent Data Monitoring Committee recommended the TOPAZ-1 Phase III trial to be unblinded at an interim analysis due to clear evidence of efficacy for IMFINZI plus chemotherapy. An additional presentation featured during the ASCO Gastrointestinal Cancers Symposium will showcase IMFINZIdata from the HIMALAYA Phase III trial, demonstrating the potential of this medicine in the treatment of unresectable liver cancer.