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Keytruda overtakes Opdivo to lead sales in global immune checkpoint inhibitor market, report reveals

Published on 19/11/19 at 03:07pm

MSD’s Keytruda (pembrolizumab) overtook Bristol-Myers Squibb’s (BMS) blockbuster drug Opdivo (nivolumab) in total sales in the third quarter of 2019 to emerge as leader in the global immune checkpoint inhibitor market, according to a new report from GlobalData.

According to the findings, MSD’s drug saw a 62% growth in revenue compared to Q3 2018 to reach $3.1 million. Over the same period, Opdivo experienced sales growth of just 1%, generating $1.8 million

“MSD attributes Keytruda’s growth in Q3 2019 to the strong uptake of the drug in combination with Pfizer’s tyrosine kinase inhibitor (TKI) Inlyta (axitinib) in the first-line treatment of metastatic renal cell carcinoma (mRCC), its uptake in the adjuvant setting in melanoma, and its continuous use in the first-line and second-line treatment of advanced non-small cell lung cancer (NSCLC),” explained Elena Tzima, Oncology and Hematology Analyst at GlobalData.

“Although BMS did not report which indications contributed the most to Opdivo’s growth, sales increase could potentially be attributed to its use in both adjuvant and advanced melanoma, as well as its use in both the first-line and second-line treatment of mRCC. Opdivo is used in more than one therapy setting in these two indications.”

While there are no available data directly comparing the efficacy of the two immunotherapy drugs, GlobalData’s report including testimony of clinical professionals who assert that they have noticed no meaningful difference between the two in practice in the treatment of renal cell carcinoma (RCC).

MSD’s product has flexed its muscles in a range of cancer indications, including melanoma, ovarian, colorectal and triple-negative breast cancer, and in a number of combinations of targeted therapies, chemotherapies and gene therapies. In the second half of this year alone, it has scooped up three new approvals: as a first-line monotherapy in non-small-cell lung carcinoma (NSCLC) in China, in combination with Inlyta in first-line RCC in Europe, and as a monotherapy for recurrent locally advanced or metastatic oesophageal cancer in the second-line and beyond in the US.

Opdivo, on the other hand, only managed to secure a change of dosing schedule within Europe in the treatment of adjuvant and metastatic melanoma.

“Yet, Keytruda is gaining ground on Opdivo in the fist-line treatment of mRCC, despite Opdivo being the first PD-1 inhibitor to be approved for the indication, in 2015 as monotherapy in second line, and in 2018 in combination with BMS’ other immune checkpoint inhibitor Yervoy (ipilimumab) in first line. Keytruda’s use in combination with Inlyta for the first-line treatment of mRCC has contributed to its success over Opdivo’s combination with Yervoy,” Tzima added.

“While the combination of Opdivo + Yervoy represents the current standard-of-care for intermediate- and poor-risk mRCC patients in the first-line setting, Keytruda + Inlyta has shown efficacy across all risk groups. Opdivo + Yervoy is arguably more toxic than Keytruda + Inlyta, due to immune-related adverse events associated with inflammation of healthy tissues that arise mainly from CTLA-4 inhibition with Yervoy, which can be avoided with the use of a TKI such as Inlyta.

“However, GlobalData expects that this will not be sufficient for Opdivo sales to surpass Keytruda’s, as Keytruda is set to become the new standard-of-care in combination with Inlyta for front-line RCC treatment.”

Matt Fellows

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