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Keytruda Threatens Avelumab, But Feels More Heat From Opdivo

Bristol-Myers Squibb’s (NYSE:BMY) Opdivo has impressed in numerous tumor types, and now looks set to add head and neck cancer to its conquests based on stunning survival data from the Checkmate-141 study presented at the AACR meeting on Tuesday.

This could help the Bristol drug extend its lead even further over Merck & Co’s (NYSE:MRK) Keytruda, though Keytruda had its own AACR success – in an academic study in Merkel cell carcinoma that could immediately hit Pfizer (NYSE:PFE) and Merck KGaA’s (OTCPK:MKGAF) avelumab. Avelumab would be especially threatened if US doctors persuaded by Keytruda, an approved drug, immediately started using it off label in this rare cancer.

It is Merkel cell carcinoma, an orphan cancer with about 2,000 new US cases a year, that Merck KGaA and Pfizer are focusing on as a potential first use for avelumab (German Merck no longer the immuno-oncology underdog, November 17, 2014). The anti-PD-L1 MAb last year got US breakthrough therapy designation in this setting.

Stealing the thunder

However, if Keytruda threatens to steal avelumab’s thunder, at AACR its own efficacy in Merkel cell was overshadowed by Opdivo’s Checkmate-141 trial, which had been halted for efficacy in January.

A more than doubling of one-year overall survival against investigator’s...