Bristol-Myers leads immuno-oncology race but Merck, AstraZeneca and Roche still have contenders

Opdivo from Bristol-Myers Squibb ($BMY) followed Merck's ($MRK) Keytruda onto the market, but the immuno-oncology drug quickly overtook its rival and has never looked back. It just today won recommendations in Europe for two more indications. But while it leads the race, analysts say there are still opportunities for Keytruda and drug candidates from others to close the gap in a market that is projected to reach $40 billion in annual sales.

Opdivo in its first full year on the market has $972 million in sales as label extensions for advanced kidney cancer and a broad label in lung cancer helped power its ascent from an initial FDA approval for melanoma. That compares to $566 million for Keytruda. BMS is testing the PD-1 inhibitor in a bunch of other cancers that will push that further. EvaluatePharma has projected 2020 sales of $8.4 billion for the drug but according to Reuters, an average of analysts put that figure at $11.1 billion.

But analysts also say there are some considerations coming that promise to change the landscape, not only for Merck and its Keytruda, but for candidates in the field from AstraZeneca ($AZN) and Roche ($RHHBY).

First off is the chance to move the drugs from approvals in advanced cancers to first-line use, and in that regard, Merck may have a leg up. Its data on Keytruda as a first-line fighter of lung cancer looks to be 4 to 6 months further along than BMS. Bernstein analyst Tim Anderson has said that could start to level the playing field for Merck.

AstraZeneca CEO Pascal Soriot

On top of that, analysts point out that while the immuno-oncology drugs have been improving overall survival in some patients, they still only work in about 25% of patients. To expand their use, drugmakers are looking at using them in combo with other new or existing cancer drugs. While AstraZeneca CEO Pascal Soriot has already conceded his company's candidate as a monotherapy, he says it is making progress as a combo drug.

Deutsche Bank is banking on AstraZeneca being the first to report out data for its drug candidate in combo with others, Reuters said, saying it may have it early next year, if not yet this year.

But others are looking at that approach as well. Merck last month added BioLineRx ($BLRX) to a fast-growing list of companies with which it is working on potential Keytruda cocktails, a group that includes GlaxoSmithKline ($GSK), Eli Lilly ($LLY), Amgen ($AMGN), Incyte ($INCY) and many others.

Finally, drugmakers are looking at their immuno-oncology therapies in combo with other older meds, an area where Roche is believed to be in the lead. In one such test, Roche last year partnered up with Clovis Oncology ($CLVS) to see whether Clovis' oral lung cancer drug can work in tandem with a closely watched injectable treatment from Roche's Genentech division.

- read the Reuters story

Special Report: The top 20 drugs in 2020--worldwide sales - Opdivo

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