Replies to post #212400 on Biotech Values

[JohnWayne]

Re: BMY / Yervoy / CTLA-4

For now, PD(L)1-naive patients ARE the entire IO market. There's no compelling evidence of what to do in PD(L)1-experienced pts. In 1L NSCLC and other tumor types, BMY and every company is trying to figure out what to add onto PD(L)1 to beat out current standards of therapy -- i.e. the low hanging fruit for monotherapy has been plucked, now the question is how to expand into more tumor types via combos.

For BMY, huge bet has been placed on CTLA-4 being the way to expand into more tumor types. What to do after these PD(L)1 combos fail is important, but that's much farther out IMO, and I don't see any reason to believe BMY has much of an advantage over the field in this endeavor.

[jq1234]

>> Since PD-(L)1-containing regimens don't work for a majority of patients, a key value driver for all of the I-O companies is going to be finding what works for patients who fail PD-(L)1-containing regimens. It seems doubtful that Yervoy (or any CTLA-4 agent) will play a significant role for those patients.

That's for PD-(L)1 monotherapy. In the largest indication 1st line NSCLC, it seems PD-(L)1 in combination with chemo, unlike monotherapy, works for majority of patients. If IO/IO combo can't carve out reasonable market share in 1st line, it will be very tough to compete from behind.

As of PD-(L)1 failure population, it is anyone's guess who would win that game. That's a tough position to be in for BMY who used to be leader in IO space. IO space changes so fast, it seems IO/chemo, IO/TKI combination will likely dominate combination for awhile since IO/IO data have been very weak lately IMO. BMY is trying to catch up in IO/chemo, IO/TKI since previous late stage focus had been on PD1/CTLA4 combo.