'Extending' the 'promise of immunotherapy'


MSD invests almost $400 million every year in Australian clinical trials, the majority involving PBS-listed immunotherapy KEYTRUDA (pembrolizumab), according to the company's Dr Bilal Piperdi.

Dr Piperdi, a thoracic medical oncologist and senior executive at MSD's global research organisation, spoke to BiotechDispatch during his current trip to Australia. 

He said Australia is the company's largest contributor to clinical trials outside the US. "Australia has well-established systems and infrastructure, with some sites involved in KEYTRUDA trials since the very first, KEYNOTE-001 in lung cancer."

"KEYTRUDA is now approved or being trialled in over one dozen tumour types and everyone is waiting for KEYNOTE-1000," he told BiotechDispatch.

Dr Piperdi trained as a medical oncologist before joining MSD around ten years ago. "We really have come a long way in terms of treating lung cancer. 

"Patient conversations have changed dramatically. Before immunotherapy, and this is just a few years ago, as a treating physician you would be talking about trying different chemotherapy options and very few patients would make it to two years.

"What we see now, with immunotherapy, is more and more are getting to two years and beyond."

His own KEYTRUDA journey started in 2013 before the therapy "even had a proper name".

"We knew it was positive but maybe even I have been a little surprised at how inhibiting one immune checkpoint can work in lung cancer. It is mind-boggling and very exciting for patients.

"We are now presenting data from KEYNOTE-001 that shows a two-year survival rate of close to 50-60 per cent. We are presenting other data that shows five-year survival of around one-third. This is leading to remarkable conversations with patients and their families.

"The challenge remains to ensure patients access therapy as early as possible, in the first-line setting, where they can really gain a survival benefit."

KEYTRUDA is reimbursed through the PBS in the first-line setting for advanced non-small cell lung cancer.

"I think we have set the bar higher in terms of survival expectations and are now 'fine-tuning' with additional combinations. This is very exciting and will help extend the promise of immunotherapy to more patients because, compared to many other cancers, there is still a lot of potential improvement in lung cancer.

"As a company, in countries like Australia, we want funded patient access as quickly as possible. Some of the combinations have already been reimbursed in other major markets and hopefully that will happen in Australia."