European Commission has approved tislelizumab in combination with chemotherapy for the first-line treatment of oesophageal squamous cell carcinoma (ESCC) and gastric or gastroesophageal junction (G/GEJ) adenocarcinoma.

“Patients diagnosed with advanced gastric and oesophageal cancers confront median survival times measured in months, not years—highlighting the urgent need for more effective treatment options,” said Prof Florian Lordick, Director and Professor of Oncology of the University Cancer Center Leipzig, Germany.

“The compelling data from the RATIONALE-305 and 306 trials underscore the unique clinical profile of tislelizumab and its potential to deliver meaningful improvements in outcomes for eligible patients, offering new hope where it’s needed most.”

In ESCC, the expanded indication is for tislelizumab in combination with platinum-based chemotherapy for the first-line treatment of adult patients with unresectable, locally advanced or metastatic cancer whose tumours express PD-L1 with a tumour area positivity (TAP) score ≥ 5%. In G/GEJ adenocarcinoma, the expanded indication is for tislelizumab in combination with platinum- and fluoropyrimidine-based chemotherapy for the first-line treatment of adult patients with HER2-negative locally advanced unresectable or metastatic cancer whose tumours express PD-L1 with a TAP score ≥ 5%.

“As the cornerstone of our solid tumour portfolio, tislelizumab is central to BeiGene’s commitment to delivering innovative treatments to as many people living with cancer as possible, with more than 1.3 million patients already treated with the medicine worldwide," said Mark Lanasa, M.D., Ph.D., Chief Medical Officer, Solid Tumors at BeiGene. "In just over a year, we have achieved approvals in the European Union across six indications, and we look forward to working to ensure that patients across Europe have rapid and broad access to tislelizumab.”

In first-line ESCC, the extension of indication application was based on results from BeiGene’s RATIONALE-306 (NCT03783442), a randomized, placebo-controlled, double-blind, global Phase 3 study to evaluate the efficacy and safety of tislelizumab in combination with chemotherapy as a first-line treatment in patients with unresectable, locally advanced recurrent or metastatic ESCC. The study enrolled 649 patients at research centers across Europe, North America and Asia-Pacific.

The study met its primary endpoint, with first-line tislelizumab in combination with chemotherapy resulting in statistically significant and clinically meaningful OS benefit compared with placebo plus chemotherapy in the intent-to-treat population. The median OS was 17.2 months for tislelizumab with chemotherapy versus 10.6 months for placebo plus chemotherapy (HR: 0.66 [95% CI, 0.54-0.80, 1-sided p-value of < 0.0001]), a 34% reduction in the risk of death.

Three-year OS in the PD-L1 ≥ 5% population was also substantially improved in favor of the tislelizumab arm (median 19.1 versus 10.0 months, respectively; HR: 0.62 [95% CI, 0.49-0.79]), demonstrating a 38% reduction in the risk of death.

The extension of indication application for first-line G/GEJ cancer was based on results from BeiGene’s RATIONALE-305 (NCT03777657), a randomized, double-blind, placebo-controlled, global Phase 3 trial to evaluate the efficacy and safety of tislelizumab in combination with chemotherapy as a first-line treatment for patients with advanced unresectable or metastatic G/GEJ cancer.

The study enrolled 997 patients at research centers across Europe, North America and Asia-Pacific. The study met its primary endpoint and demonstrated a statistically significant and clinically meaningful overall survival (OS) benefit with a median OS of 15.0 months for patients treated with tislelizumab in combination with investigator’s choice of chemotherapy compared to 12.9 months for patients treated with placebo plus chemotherapy (n=997; HR: 0.80 [95% CI: 0.70, 0.92]; P=0.0011), resulting in a 20% reduction in the risk of death. In the PD-L1 ≥ 5% population, the median OS was 16.4 months for tislelizumab plus chemotherapy compared to 12.8 months for the placebo arm (HR: 0.71 [95% CI, 0.58-0.86]), which represents a 29% reduction in the risk of death.

The safety data in the applications included more than 2,800 patients who received tislelizumab as either monotherapy (1,534) or in combination with chemotherapy (1,319) at the approved dosing regimen. The most common Grade 3 or 4 adverse reactions (≥ 2%) for tislelizumab given in combination with chemotherapy were neutropenia, thrombocytopenia, anemia, fatigue, hypokalemia, hyponatremia, pneumonia, decreased appetite, rash, lymphopenia, alanine aminotransferase increased, aspartate aminotransferase increased, diarrhea, pneumonitis, and hepatitis.

Tislelizumab is also approved in the EU for eligible patients with unresectable, locally advanced or metastatic ESCC after prior platinum-based chemotherapy and for three NSCLC indications covering both the first- and second-line settings.

The Company recently announced its intent to change its name to BeOne Medicines Ltd., reaffirming its commitment to develop innovative medicines to eliminate cancer by partnering with the global community to serve as many patients as possible.

About Gastric and Gastroesophageal Junction (G/GEJ) Adenocarcinoma

Gastric (stomach) cancer is the fifth most common cancer worldwide and the fifth highest leading cause of cancer mortality. Nearly 1 million new patients were diagnosed with gastric cancer in 2022, and 660,000 deaths were reported globally. Gastroesophageal junction adenocarcinoma occurs at the area where the oesophagus joins the stomach, which is just beneath the diaphragm (the thin sheet of breathing muscle under the lungs).

Source: BeiGene