Bristol-Myers Squibb could double patient numbers for Opdivo in kidney cancer

The front-line kidney cancer opportunity in the U.S. could be twice as big for Opdivo as its current second-line opportunity.

Now that Bristol-Myers Squibb’s Opdivo has safely posted growth in 2017, all eyes are on what the drug can pull off next year. Its move into a larger kidney cancer market will be central to that equation.

As Bristol-Myers commercial chief Murdo Gordon said on last week’s third-quarter conference call, the pool of previously untreated kidney cancer patients in the U.S. is roughly twice the size of the group that's failed one round of therapy. That's about 16,000 first-line patients. Depending on FDA labeling in that indication, that “could be a very, very interesting opportunity for us,” he said.

RELATED: Bristol-Myers' Opdivo-Yervoy cocktail slashes kidney cancer death risk by 37%

The company is looking to build on its presence in second-line renal cell carcinoma, where Opdivo “has done a nice job” versus tyrosine kinase inhibitors, Gordon said. It currently boasts a more than 50% market share, and it’s “holding,” he added.

And while better treatment up front with Opdivo could cannibalize the drug's second-line sales, that won’t happen quickly.

Because this is a slower-moving malignancy in terms of progression, the effect on second-line will take longer to materialize than you might see in other malignancies,” Gordon said. “So at least for next year, you're going to have a nice overlap of an uptake in first-line, if all goes well, and a continuing robust business in second-line.”

RELATED: Bristol-Myers' Opdivo drives another top-line beat in Q3, but lung-cancer combo data looms

Analysts are laser-focused on what next year might hold for Opdivo—though understandably, they’re most eagerly anticipating results from a phase 3 trial of the Opdivo-Yervoy tandem in non-small cell lung cancer. Bristol previously failed a front-line trial for solo Opdivo in the all-important market, which is immuno-oncology’s most lucrative.

But the medication has some additional growth opportunities outside of lung and renal. One is in melanoma patients who've undergone surgery, where the blockbuster has already put up positive data. It also recently launched in liver cancer, and “the anecdotal early feedback on that is ... very strong,” Gordon said.

Still, in a market as unpredictable as immuno-oncology, it’s hard to say what next year has in store.

“I think we've been very good in terms of the commercial and medical and customer-facing execution, and I feel that we would do everything we can to have a strong performance next year," Gordon said. "But obviously, there are a lot of variables and a lot of data sets still to read out, and we'll be talking to you over the quarters as we go."