- Bristol-Myers Squibb continued to see positive results from an experimental combination of its two immunotherapy drugs Opdivo and Yervoy, which together helped shrink tumors in nearly half of patients with advanced non-small cell lung cancer (NSCLC) tested in a Phase 1b trial, the company said over the weekend.
- Among patients dosed with Yervoy less frequently, the overall objective response rate (ORR) was 47%, while those patients who received Yervoy more often saw an ORR of 39%.
- The Opdivo/Yervoy combination has previously shown benefit in treating melanoma, and has won FDA approval for treating certain types of that cancer.
New immuno-oncology drugs like Opdivo and Merck's Keytruda have shown tremendous promise, but not all patients see the same positive responses. Higher expression of a specific protein known as PD-1/PD-L1 on tumor cells has been correlated to improved responses, leading companies to target that protein. Drugmakers have also turned to combinations as a way to potentially improve the effectiveness of immunotherapies.
The benefit of both approaches can be seen in Bristol-Myer's trial of Opdivo and Yervoy against NSCLC. Among patients with greater than 1% expression of PD-L1, overall response rates hit 57%. in the 13 patients who had greater than 50% PD-L1 expression, 12 saw some repsonse to treatment.
Combining Opdivo with Yervoy also led to greater benefit, as patients treated with Opdivo alone only saw an ORR of 23%, although the study was not designed to directly compare treatment arms.
Lung cancer is one of the most deadly forms of cancer, and NSCLC is the most common type of lung cancer. According to the American Cancer Society, 158,000 patients die from NSCLc each year. Typically, the disease is treated with chemotherapy regimens, although those can cause toxic side effects.
The Opdivo/Yervoy combination also presented some serious side effects, with 37% of patients experiencing grade 3 or 4 adverse events in the arm dosed with Yervoy less frequently. Side effects led to discontinuation of treatment in 5% of patients in that arm, but in 10% of patients treated with Opdivo alone.
Merck, Bristol's rival in the immuno-oncology space, also got positive data from an ongoing Phase 1/2 testing its cancer drug Keytruda with Yervoy against advanced melanoma. Among the 153 evaluable patients treated with the two drugs, 57% experienced a complete or partial response.
As the first immunotherapy approved in the U.S., Yervoy has been a frequent choice for testing of combination therapies. Such treatments aim to elicit specific immunologic repsonses at different points in the disease's pathway, while also targeting stray mutated cells.