With ASCO data tallied, Bristol-Myers loses ground to Merck in I-O field

ASCO
Merck prevailed at ASCO with several sets of promising Keytruda results.

If Bristol-Myers Squibb needed more evidence to suggest it had lost the immuno-oncology lead to Merck & Co., it got it at the American Society of Clinical Oncology meeting.
 
Thanks to a raft of promising Keytruda results—in tandem with Incyte IDO inhibitor epacadostat, in certain high-risk breast cancers and in combination with chemo in lung cancer, to name a few—multiple industry watchers crowned the New Jersey pharma giant the I-O field’s weekend victor.
 
Moody’s, for one, released a report declaring Merck among the three drugmakers most likely to benefit from their ASCO showings. Leerink Partners analyst Seamus Fernandez wrote in a note to clients that Merck had “clearly won the battle of small datasets” at the conference.
 
And Barron’s put out a post-ASCO article asking, “Is Bristol-Myers falling behind?,” noting that “investor perception today may be that competitors have caught up with the company’s progress” and that “in the near-term the fight is uphill” for Merck’s main rival.
 
Bristol, meanwhile, didn’t impress investors with its two-year survival update on its Opdivo-Yervoy one-two punch in first-line lung cancer. Data showed “similar results” between the combo-treated group and the Opdivo-only arm, and in patients with levels of PD-L1 expression at 50% or higher, “the results are actually better with monotherapy,” Credit Suisse analyst Vamil Divan wrote to clients Saturday.
 
Opdivo, the first PD-1/PD-L1 med to jump into the all-important lung cancer space, once held the favor of investors and analysts alike. But things took a turn last summer when Bristol announced its superstar had flopped a phase 3 monotherapy trial in first-line lung cancer. Keytruda went on to succeed on its own and snag an indication, turning attention to the first-line lung cancer combo battle.
 
Once again, Merck prevailed, surprising the markets with an early filing for a marriage of Keytruda and chemo. Bristol, in contrast, passed on the chance to file its Opdivo combo—which pairs the med with Yervoy—instead tweaking its study to delay results.
 
That’s not to say that Bristol hasn’t had its recent wins—or that it didn’t turn out any positive ASCO data of its own. BMS, which went into the meeting fresh off an FDA priority review designation in liver cancer, announced positive phase 2 results for the Opdivo-Yervoy combo in hard-to-treat mesothelioma, a disease BMS’ oncology development head, Fouad Namouni, said was once referred to as a “graveyard of drug development.”
 
The company has also forayed into trials with new immuno-oncology targets, producing LAG-3 data that “looked interesting,” Divan pointed out.
 
“We think it’s clear that Bristol is doing some genuinely interesting science and taking worthwhile risks with next-gen agents like LAG3, IDO and GITR that could meaningfully pay off down the road,” Barclays’ analyst Geoff Meacham added in his own investor note.
 
And while Moody’s does see Keytruda “surpassing” Opdivo “within the next several quarters,” it noted that “the longer-term outlook for Opdivo is still strong based on numerous studies underway in a variety of cancers.”
 
Still, though, analysts have their questions, especially surrounding the lung cancer performance.
 
“Without question, there is more to Bristol’s investment case than just front-line lung, but the lack of clarity on how it will get to participate in this important market segment over the intermediate term outweighs the otherwise impressive discovery and translational efforts,” Meacham wrote.