BMS' Opdivo-Yervoy combo posts big win in first-line lung cancer—but big enough to challenge Merck?

opdivo
First-line lung cancer patients in the Checkmate-227 trial receiving Bristol-Myers Squibb's Opdivo-Yervoy combo were 42% less likely than those in the control arm to see their disease progress. (Bristol-Myers Squibb)

Back in February, Bristol-Myers Squibb tallied a win for its immuno-oncology combo in first-line lung cancer. But one question still remained: Was the win big enough to keep it competitive against rivals?

Details on that trial victory hit Monday at the American Association for Cancer Research annual meeting. Bristol-Myers trumpeted results showing that after a minimum follow-up of 11.5 months, patients with high tumor mutational burden (TMB) receiving a combination of BMS’ Opdivo and Yervoy were 42% less likely to see their disease worsen than those receiving standard-of-care therapy.

Overall, 45.3% of those in the Opdivo-Yervoy arm of the study, dubbed Checkmate-227, responded to the therapy, while just 26.9% of patients in the control group did. And what’s “even better” is that those responses were durable, BMS’ oncology development head, Fouad Namouni, M.D., said. Among those who responded to the BMS cocktail, 68% maintained their gains against the disease at the one-year mark, while just 25% of chemo responders could say the same. 

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The data are “extremely important,” and they “contribute to really define the utility of chemo,” Namouni said, adding that Bristol-Myers now has “a much deeper and better understanding of the biology of lung cancer. I think this is really a major advance.”

RELATED: Bristol-Myers' Opdivo-Yervoy team scores coveted win in first-line lung cancer

Unfortunately for the company, though, investors eager to predict first-line market share are constantly comparing its regimen to those of its rivals, and big new data from Merck’s Keytruda-chemo combo may partially overshadow Bristol-Myers’ win.

Also on Monday, Merck put up results showing that its Keytruda-chemo pairing could slash patients’ risk of death by 51%. Plus, the Keytruda-combo patients all saw a significant survival benefit, regardless of their PD-L1 biomarker status.

RELATED: With big Keytruda and Opdivo data coming at AACR, analyst hands Merck the early edge

“Our belief is that once both data sets are presented in full and side-by-side comparisons are done, MRK will appear to be the more victorious of the two companies at AACR,” Bernstein analyst Tim Anderson predicted Friday, thanks to Bristol-Myers’ more limited, TMB-focused patient population.

The way Namouni sees it, though, having biomarker-specific results is a good thing. “When you have the right patients with the right precise marker, I think physicians and patients will be interested in knowing their TMB status,” he said, adding that TMB could join the ranks of EGFR, ALK, ROS and other biomarkers for which doctors now regularly test.

“This is a journey” of better understanding the biology of lung cancer “and having the right medicines for the right patients,” he said.