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New BMS cancer treatment shines

pharmafile | June 25, 2014 | News story | Research and Development, Sales and Marketing ASCO, BMS, Cancer, Yervoy, braf, melanoma, nivolumab 

Bristol-Myers Squibb’s investigational cancer treatment nivolumab has helped patients with the deadliest form of skin cancer to live longer.

The drug, known as a PD1-inhibitor, was one of the stars at the ASCO cancer conference in Chicago last month, and is tipped for blockbuster sales.

It is being tested in patients with previously untreated BRAF wild-type advanced melanoma, and being compared to the older chemotherapy treatment dacarbazine.

The trial was stopped early because an analysis conducted by the independent Data Monitoring Committee showed nivolumab’s superior overall survival (OS) compared to the control arm.

This is a major coup for the firm as increasing OS is the so-called ‘golden endpoint’ in any oncology trial, but is rarely achieved – especially in melanoma – as it is a notoriously aggressive cancer when in the later stages of the disease.

Patients in the trial will now be un-blinded and allowed to cross-over to nivolumab for ethical reasons – BMS adds that it will share these data with health authorities.

The drug works as a fully-human PD-1 immune checkpoint inhibitor that binds to the checkpoint receptor PD-1 (known as programmed death-1) expressed on activated T-cells.

BMS and its development partner for the drug Ono Pharmaceuticals, are investigating whether by blocking this pathway, nivolumab would enable the immune system to resume its ability to recognise, attack and destroy cancer cells.

Michael Giordano, head of BMS’s oncology development, says: “Bristol-Myers Squibb is committed to continuing to lead advances in immuno-oncology and to executing our strategy to provide patients with the best opportunity to achieve the potential for long-term survival.”

Nivolumab is also being tested for both early-stage and late-stage non-small cell lung cancer. Barclays analyst Tony Butler estimates that nivolumab could eventually generate annual global sales of $6 billion for its use in lung cancer alone.

Building on Yervoy’s success

BMS already has a successful melanoma cancer treatment on the market in the form of its Yervoy (ipilimumab), one of the first medicines for melanoma to increase overall survival.

Yervoy costs £80,000 for a full course of treatment and is on course to make $2 billion in peak sales by 2018, according to analysts.

BMS will hope its latest treatment for the disease will be able to replicate these results, and is also testing its new medicine with Yervoy to see if a combination treatment could be more effective.

But it will not be alone in treating this particular genetic mutation as Roche’s Zelboraf (vemurafenib) which has been on the market for a few years now, is also licensed to treat BRAF positive melanoma patients. Roche’s medicine is expected to bring in around $700 million in peak annual sales.

The Swiss firm also has a PD-1 melanoma drug in development, as does Merck – analysts believe this new market could be worth in excess of $10 billion should they all succeed in Phase III testing and gain approval. Both firms are also testing their PD-1 drugs in lung cancer as well as for other targets.

The incidence of melanoma has been increasing for at least 30 years and in 2012, an estimated 232,130 melanoma cases were diagnosed globally.

Melanoma is mostly curable when treated in its early stages, but in its late stages the average survival rate has historically been just six months with a one-year mortality rate of 75%, making it one of the most aggressive forms of cancer.

Ben Adams 

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