Bristol-Myers Squibb's Opdivo, Yervoy put the brakes on mesothelioma in phase 2

CHICAGO—New phase 2 data suggest immunotherapy could stall mesothelioma progression—and that when it comes to Bristol-Myers Squibb’s checkpoint inhibitors, two might be better than one.

Early results unveiled Monday at the American Society of Clinical Oncology annual meeting showed that Bristol’s PD-1 med Opdivo and CTLA4 drug Yervoy slowed disease growth in patients with relapsed malignant pleural mesothelioma (MPM). At the 12-week mark, cancer hadn’t worsened in 44% of patients treated with Opdivo and 50% of those treated with the Opdivo-Yervoy combo, Bristol said.

The two-drug combo edged Opdivo monotherapy elsewhere, too. Solo, Opdivo held off cancer progression for a median four months, while the tandem treatment staved off the advance of the disease for a median 5.6 months. And when it came to extending patients' lives, the Opdivo-only cohort posted a 10.4 month median overall survival, while patients taking the immunotherapy duo hadn’t yet hit the median.

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Those are big numbers, considering that MPM is a “devastating” disease that currently lacks treatment options, BMS’ oncology development head, Fouad Namouni, said in an interview.

“I think it’s great news for patients and one more proof that combining agents and not being shy of tackling very difficult diseases—diseases that I remember, back when, we called them the graveyard of drug development—now we are making them happen with combination therapies,” he said.

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Opdivo and Yervoy already have one joint approval, and that’s in inoperable or metastatic melanoma. They’re under investigation together in other tumor types, though, too, including gastric cancer and bladder cancer.

“I think we very early on at Bristol knew that it’s not going to be immunotherapy as a monotherapy” that would bring the best survival benefits for patients, Namouni said. “We very early on noticed that adding ... Yervoy to Opdivo will improve the response rates, improve the progression-free survival, and improve the survival,” he said.  

The key question for the one-two punch, though, is whether it can get the job done in first-line lung cancer. Now that Opdivo has failed in that setting as a monotherapy—and rival med Keytruda has succeeded—there’s even more riding on the combo, which is now in testing as a first-line treatment, than there once was.