When Bristol Myers Squibb and Exelixis first unveiled kidney cancer data for the combination of Opdivo and Cabometyx last fall, industry watchers couldnt determine a clear winner between that duo and Merck & Co. and Pfizers Keytruda-Inlyta cocktail. Now, with longer-term data, the jurys still out.<\/p>\n
In previously untreated kidney cancer, the Opdivo-Cabometyx combo slashed the risk of death by 34% compared with Pfizers older drug Sutent. The data, from a 23.5-month follow-up of the phase 3 CheckMate-9ER trial, was released for the virtual American Society of Clinical Oncology 2021 Genitourinary Cancers Symposium.<\/p>\n
Sutent patients lived amedian 29.5 months after therapy, while the median overall survival for the Opdivo-Cabometyx combowas not reached, Jonathan Cheng, M.D., BMS head of oncology development, said in an interview.<\/p>\n
The life-extension data again looked very similar to what Keytruda and Inlyta previously posted in the Keynote-426 trial. In that phase 3, after a minimum of 23 months of follow-up, the risk reduction was 32%, which may seem slightly below that of the Opdivo regimen.<\/p>\n
Notice the difference between the median and the minimum between the two data cutoffs, though. In fact, according to results published in The Lancet Oncology, the Keytruda-Inlyta combos 32% death risk reduction still held true after a median follow-up of 30.6 months.<\/p>\n
RELATED:How will BMS' new Opdivo-Cabometyx kidney cancer combo fare against Keytruda? It may come down to marketing: analyst<\/p>\n
Overall survival benefits appear to shrink for immuno-oncology regimens in front-line kidney cancer as follow-up continues. Previously, at the 18-month follow-up mark, the risk reduction amounted to 40% for the Opdivo-Cabometyx therapy; the rate was 41% for Keytruda-Inlyta after 17 months.<\/p>\n
On some of the other efficacy markerssuch as risk reduction on tumor progression, the rate of tumor response and duration of responsethe two regimens both have wins against each other.<\/p>\n
While its still hard to make a solid judgment between the two regimens, Cheng pointed to Cabometyxs long experience in kidney cancer since its first FDA approval in 2016. <\/p>\n
Cabo is specifically well-known to the kidney cancer oncologic community ... because it has single-agent approval, and the safety profile is well-understood, including the discontinuation rate, he said.<\/p>\n
But as one analyst sees it, thefirst-line kidney cancer I-O\/TKI winner may be a different regimenentirely. That title may belong to Merck and Eisais Keytruda-Lenvima pairing, SVB Leerink analyst Daina Graybosch said in a Tuesday note to clients.<\/p>\n
RELATED:Merck, Eisai further complicate kidney cancer race with Keytruda-Lenvima win<\/p>\n
At ASCO GU, Merck and Eisai will show that Keytruda and Lenvima cut the risk of deathalso by 34%after 24 months of follow-up in theKeynote-581 trial. But Graybosch pointed to several bright spots in the datasetin favor of the new contender.<\/p>\n
Specifically, the Keytruda-Lenvima duo cut the risk of disease progression or death by a whopping 61% over Sutent, higher than the 48% and 29% for Opdivo-Cabo and Keytruda-Inlyta, respectively. The trial also found a better tumor response rate, longer duration of response, and more complete responses in Keytruda-Lenvima patients.<\/p>\n
Industry opinion leaders believe complete response rate predicts long-tail survival, Graybosch said. Cross-trial comparisons should be made with caution, given differences in study design and baseline patient profile.<\/p>\n
Graybosch said she will keep a close eye on some important details on treatment discontinuation rate, where, as Cheng hinted, Opdivo-Cabo looks to have the best profile.<\/p>\n
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The rest is here: <\/p>\n
ASCO GU: With 2-year data, the jury's still out on the kidney cancer race between Opdivo-Cabometyx and Keytruda-Inlyta - FiercePharma<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" When Bristol Myers Squibb and Exelixis first unveiled kidney cancer data for the combination of Opdivo and Cabometyx last fall, industry watchers couldnt determine a clear winner between that duo and Merck & Co. and Pfizers Keytruda-Inlyta cocktail. Continue reading