No magical surprise for Astra in ATR inhibition

It would indeed have been a surprise if AstraZeneca’s ATR inhibitor ceralasertib had worked in post-immunotherapy lung cancer, and on Monday the company failed to pull a rabbit out of the hat, confirming the failure of the phase 3 Latify study. This trial compared ceralasertib plus Imfinzi against docetaxel in 594 NSCLC patients who had progressed on anti-PD-(L)1 therapy and platinum-based chemo, and represented one of the few remaining late-stage attempts to shore up this troubled mechanism of action. Earlier setbacks for ATR inhibition include the stopping of Repare’s camonsertib after Roche scrapped a licensing deal, and the discontinuations of Bayer’s elimusertib and Merck KGaA’s berzosertib. Ceralasertib itself had its phase 2 Monette study, testing an Imfinzi combo in post-IO melanoma, halted for futility two years ago. The Astra project remains in the phase 3 NCI-sponsored Clear study in adjuvant NSCLC, and this is the last remaining pivotal trial of any ATR inhibitor, according to OncologyPipeline. The most advanced asset still in development is probably Merck KGaA’s tuvusertib, in several phase 2 trials.

Pivotal trials of ceralasertib

Note: *NCI-sponsored study. Source: OncologyPipeline.