Replies to post #195900 on Biotech Values

[DewDiligence]

Re: PD-L1 expression test

Here’s a write-up by an MD who disagrees with you and thinks patients receiving Opdivo in second-line NSCLC should be (and generally will be) tested for PD-L1 status:

http://t.co/ksg3zimx7L

We’ve seen overall survival curves by PD-L1 expression with Opdivo, which clearly show that the patients with PD-L1 expression do better with Opdivo than with Taxotere, while there are no significant differences between the two for patients without PD-L1 expression. However, the PFS curve really indicates that a large proportion of patients are likely rescued by getting subsequent effective non-immunotherapy treatment, and they end up with a comparable survival after starting with Opdivo despite starting with Opdivo, not because of it. The “hazard ratio” for Opdivo vs. Taxotere among PD-L1 negative with a PD-L1 expression (cutoff of 1%) is 1.19, which wasn’t statistically significant but suggests a better result with chemotherapy.

I don’t think this author has convincingly made a case for Opdivo inferiority relative to Taxotere in PD-L1-negative patients, but there may be enough murkiness that many docs prescribing Opdivo in second-line NSCLC will opt to test for PD-L1 after all.