Lung cancer patients in advanced stages of the disease received a new first-line treatment option on Friday. The FDA has approved the combination of Opdivo plus Yervoy from Bristol-Myers Squibb (BMY -0.42%) as a treatment for patients with non-small cell lung cancer (NSCLC) tumors that express programmed death-ligand one (PD-L1) on at least 1% of their cells.
Lung cancer isn't the most commonly diagnosed malignancy, but it claims more lives than any other, and NSCLC cases comprise around 85% of all lung cancer diagnoses. As a first-line treatment for NSCLC patients, annual sales of Opdivo's top competitor, Keytruda from Merck (MRK), soared 55% in 2019 to $11.1 billion largely due to first-line NSCLC patients that tend to remain on therapy much longer than patients that have already relapsed.
Competition for Keytruda's NSCLC position?
In the first quarter of 2020, Opdivo sales slid 2% compared to the previous year period to an annualized $7.1 billion. Although it's Bristol's third-largest revenue stream at the moment, this first-line NSCLC expansion could make the Opdivo plus Yervoy combination Bristol's lead growth driver in the second half of 2020.
Opdivo plus Yervoy were specifically approved to treat advanced-stage NSCLC patients with PD-L1 positive tumors that don't display epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) mutations. Keytruda is approved to treat the same group as a monotherapy and in combination with standard chemotherapy regardless of PD-L1 status. Keytruda plus chemo is also approved to treat around a third of NSCLC patients sub-classified as squamous regardless of their EGFR, and ALK mutation status.