Merck's Keytruda slashes death risk by 31% in esophageal cancer victory

Back in November, Merck & Co. said its immuno-oncology star, Keytruda, had topped chemo at lengthening the lives of some esophageal cancer patients. Monday, it showed that the win was a sizable one.

The drug reduced the risk of death by 31% in previously treated patients with esophageal or esophagogastric junction carcinoma whose tumors expressed certain levels of biomarker PD-L1, Merck said, making Keytruda the first in its class to demonstrate a survival benefit in that group of patients.

That result could also make it the first in its class to score an approval. Esophageal cancer is the seventh most commonly diagnosed cancer worldwide, and it’s projected to affect 17,650 U.S. adults this year. An estimated 572,000-plus new cases were diagnosed worldwide in 2018, Merck said.

"Esophageal cancer often progresses aggressively, so we are encouraged to see these overall survival results for Keytruda as monotherapy in previously treated patients," Roy Baynes, M.D., Merck SVP and head of global clinical development, said in a statement.

Merck is hoping to add esophageal cancer to a host of other Keytruda monotherapy approvals, including those in lung cancer, melanoma and bladder cancer. But at this point, the majority of the drug’s future potential lies in combinations, company R&D chief Roger Perlmutter said at last week’s J.P. Morgan Healthcare Conference.

"We mounted an effort starting five years ago to explore the full use of the molecule in monotherapy," and "we’re getting to the point where most of that monotherapy work is done," he said.

But that’s not a bad thing for the New Jersey drugmaker. In lung cancer, for one, Keytruda has shown that combining Keytruda with chemo can unlock greater efficacy, setting the drug up for more significant sales down the line.

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