MSD’s interim Keytruda combo data spooks Roche and BMS

When PD-1/L1 treatments first came on the market, there was a race to snaffle as many indications as possible for the therapies. Since then, the market has moved on again and the new competition is to see which company can get a combination therapy onto the market first.

AstraZeneca, notoriously, tried and fail – failing to boost progression-free survival (PFS) in first line non-small cell lung cancer, with its shares tanking by 16% of the news.

Now, MSD (known as Merck in North America) has stepped up the plate and revealed its own combination trial results. It is bad news for everyone else in the field, as MSD reported that Keytruda, alongside Eli Lilly’s Alimta and cisplatin or carboplatin had met its dual primary endpoints in overall survival (OS) and PFS.

The interim data was not revealed, with this expected to be announced at an upcoming medical meeting, but MSD was confident enough to conclude that the combination therapy "resulted in significantly longer OS and PFS" compared with a therapy of just Alimta in combination with chemotherapy.

"KEYNOTE-189 showed significant improvement in overall survival and progression-free survival for patients receiving Keytruda in the first-line setting in combination with traditional chemotherapy, compared with those receiving chemotherapy alone," said Dr Roger M. Perlmutter, President, MSD Research Laboratories. "We are deeply grateful to the KEYNOTE-189 patients and investigators for their important contributions to this landmark study, and we look forward to presenting the data in the near future."

MSD shares rose by 7.3%, at the time of reporting, while Roche’s fell by 3.6% and Bristol-Myers Squibb’s reacted much the same, down 3.6%.

Roche has been firmly settled in third place since entering the market with Tecentriq but had been hoping to make a leap forward by being the first to achieve strong combination data; BMS is also working on combinations for Opdivo.

The race is not run yet, depending on how each company’s data pans out may well influence which is the stronger option; however, this adds to the head of steam that Keytruda has already been building.