Toripalimab (Loqtorzi)

Key Messages

• Canada’s Drug Agency (CDA-AMC) recommends that Loqtorzi be reimbursed by public drug plans in combination with gemcitabine plus platinum chemotherapy for the first-line treatment of adults with metastatic or with recurrent, locally advanced nasopharyngeal carcinoma (NPC) if certain conditions are met.
• The pan-Canadian Oncology Drug Review Expert Review Committee (pERC) determined that Loqtorzi demonstrates acceptable clinical value versus gemcitabine plus cisplatin in patients with metastatic or recurrent, locally advanced NPC. This determination was enough for pERC to recommend that Loqtorzi be reimbursed. Given that Loqtorzi is expected to be an additive treatment to gemcitabine plus platinum chemotherapy, acceptable clinical value refers to added value versus gemcitabine plus platinum chemotherapy.
• Evidence from a clinical trial (JUPITER-02; N = 289) demonstrated that, when compared to gemcitabine and cisplatin, treatment with Loqtorzi plus gemcitabine and cisplatin likely results in added clinical benefit in delayed disease progression and in patients living longer (improved overall survival [OS]) in patients with recurrent or metastatic NPC.
• Loqtorzi plus gemcitabine and cisplatin was considered an additive therapy to gemcitabine plus platinum chemotherapy, and there was a higher incidence of immune-mediated adverse events (AEs) associated with Loqtorzi plus gemcitabine and cisplatin. Additionally, there was a large amount of missing data for health-related quality of life (HRQoL) outcomes.
• Loqtorzi should only be covered for adult patients with recurrent, locally advanced NPC (i.e., NPC that cannot be controlled with local treatments such as surgery or radiation) or NPC that has spread to other parts of the body, in line with the sponsor’s reimbursement request. Patients should also have good performance status and must not have received prior anticancer therapy for recurrent or metastatic NPC.