BMS cancer agent stacks up against Merck's, but AZ's IO steals show

BMS cancer agent stacks up against Merck's, but AZ's IO steals show
BMS cancer agent stacks up against Merck's, but AZ's IO steals show

Late- and early-stage immunotherapy results shared the spotlight at the European Society of Medical Oncology this past weekend in Madrid.

Among the immuno-oncology treatments for which attendees received significant updates were Bristol-Myers Squibb's Phase-III PD-1 inhibitor Opdivo, tested in patients who had previously been treated with BMS melanoma IO drug Yervoy.

In an interim analysis, Opdivo outperformed chemotherapy in patients with advanced melanoma by a considerable margin, with the drug inducing a 32% overall response rate, compared to 11% in chemo patients, the company said.

Leerink Swann analyst Seamus Fernandez wrote in an investor note this morning that the Opdivo results match up well against Merck's Keytruda: “These results, at a minimum, confirm to us that Opdivo 3 mg/kg every 2 weeks is at least as good as [Keytruda's] 2mg/kg every 3 week dose.” Keytruda, the first PD-1 available in the US, was approved in early September.

The results of Opdivo's safety test were heralded by clinicians at the conference as signaling “the beginning of the end of chemo in melanoma.” Investigators observed drug-related adverse-events in just 9% of Opdivo-treated patients vs. 31% of chemo-treated patients.

In that same investor note, Fernandez wrote, “[I]nterestingly, it is estimated that at least 30% of US patients and >50% of outside U.S. patients diagnosed with melanoma are still receiving first or second-line chemotherapy,” signaling that Opdivo could fulfill a huge unmet need in skin cancer.

Strong skin cancer results aside, Opdivo wasn't able to extend that enthusiasm into lung cancer—where AstraZeneca stole the show. The British drugmaker revealed dose-ranging data and efficacy of its combo of MEDI-4736, an anti-PDL, and tremelimumab, an anti-CTLA4 in treatment-resistant patients with non-small cell lung cancer in a Phase-I trial.

Fernandez wrote that the data presented on the combo “appears to be a better tolerated combination than Opdivo based on data presented at ASCO (American Society of Clinical Oncology) 2014.” The rate of treatment-related adverse events which led to discontinuation were 13-17% for AZ, while BMS observed rates of 35%, according to Fernandez.

Its tolerability combined with a 30% overall response rate, he noted, “has continued to generate ‘buzz' among clinicians.”

And while he stopped short of declaring AZ's combo ahead of Opdivo, the analyst did add that, “[W]e believe these admittedly very preliminary results set a higher bar for Bristol-Myers Squibb's presentation of the 1/1 combination with Opdivo/Yervoy.”