AstraZeneca Combination Cuts Risk of Lung Cancer Progression by 44% in SANOVO Trial
Key Facts
AstraZeneca said the combination of ORPATHYS and TAGRISSO reduced the risk of disease progression or death by 44% compared with TAGRISSO alone, in detailed results from the SANOVO trial published in 2026. The study included patients with advanced or metastatic non-small-cell lung cancer, an EGFR mutation and MET overexpression who had not received prior treatment. Median progression-free survival was 24.9 months for patients who received the combination, versus 13.8 months for the TAGRISSO-only group. The results test the use of the combination as first-line treatment, while the combination was approved in China for cases treated after progression on an EGFR-TKI. The company said ORPATHYS is jointly developed with HUTCHMED, while AstraZeneca is responsible for its marketing.
The effect was greater among patients with high MET overexpression, with the risk of disease progression or death reduced by 55% compared with monotherapy, AstraZeneca said. In this group, median progression-free survival was 24.8 months with the combination, versus 11.1 months with TAGRISSO alone. These results place the difference between the treatments in the subgroup at the center of the trial findings, alongside the result recorded in the overall patient population. Lead investigator Yi-Long Wu said treating the EGFR and MET pathways from the start of treatment could offer a new approach for these patients. Wu described the regimen as a "biomarker-guided oral therapy," linking its rationale to targeting both pathways from the outset.
The trial included 326 patients who had not previously received treatment, randomly assigned in a 1:1 ratio to the combination or comparator treatment. The study designated progression-free survival, as assessed by investigators, as a primary endpoint. Other endpoints included overall survival, objective response rate and safety. The trial design directly compares the combination with TAGRISSO alone in eligible patients, rather than with no treatment. Progression-free survival data provide a measure of how long patients live before their disease progresses, while the study follow-up also includes overall survival outcomes.
AstraZeneca had announced positive high-level topline results from SANOVO on September 1, 2026. The company said at the time that the trial would continue to track overall survival outcomes. The current detailed results follow that announcement, while overall survival remained among the study's other endpoints, alongside objective response rate and safety. The results announcement available here did not include an overall survival figure or details of the safety results, so these findings do not provide a final outcome for either measure. Continued follow-up of participants remains part of the trial after the progression-free survival results were announced.
The next announced step in the regulatory process is a supplemental application by HUTCHMED in China to make the combination available as initial treatment. This use differs from the existing approval there, which covers patients with non-small-cell lung cancer with an EGFR mutation and MET amplification after progression following treatment with an EGFR-TKI. SANOVO follow-up is therefore focused on whether the first-line results will support expanding use within China's regulatory framework. The source did not specify a date for submitting the application or for a decision. AstraZeneca shares closed at $171.49 on October 23, 2026, according to EL7 data.