Bavencio’s forgotten lung cancer readout is a dud

It is a measure of the stranglehold that Keytruda has on front-line lung cancer that the failure of Bavencio in the Javelin Lung 100 trial in this setting was today revealed as a mere footnote in Pfizer’s fourth-quarter earnings. Not that Pfizer and Merck KGaA had not maximised the trial’s chances of success: Javelin had twice been enlarged, was refocused on PD-L1 expressers and had its primary endpoints overhauled. But protracted delays – readout had originally been slated for April 2019, before being put back four times – meant that Keytruda made hay while Javelin’s results receded into near irrelevance. Today Pfizer said Bavencio had shown “clinical activity” but failed to beat chemo on the OS and PFS co-primary endpoints. In the changing NSCLC environment it is possible that control cohort patients went on to receive efficacious anti-PD-(L)1 therapy, including Keytruda, but it is increasingly looking as though Bavencio simply is not a particularly good drug. Its last US approval, in first-line bladder cancer maintenance, occurred in mid-2020.