Mer­ck cau­tious­ly steps in­to the PD-(L)1/CT­LA-4 check­point fray. But should it ‘go big or go home’ in­stead?

Mer­ck’s strat­e­gy on de­vel­op­ing its PD-1 check­point drug Keytru­da could be sum­ma­rized as: If we have any kind of a shot at a le­git­i­mate tar­get, we’re go­ing to take it. Then we’ll start a com­bo tri­al AS­AP.

Now it’s moved in­to an ear­ly-stage study in what is loom­ing as the next big chal­lenge that will ei­ther dis­tin­guish the lead­ers or set up the next great pit­fall: A PD-(L)1/CT­LA-4 com­bo.

The think­ing be­hind this, out­lined in a note from Bern­stein’s Tim An­der­son, helps il­lus­trate just how in­tense­ly com­pet­i­tive this game of block­busters has be­come, pit­ting Mer­ck $MRK against Bris­tol-My­ers Squibb $BMY (again) and a very am­bi­tious group at As­traZeneca $AZN that has been mak­ing some close­ly-watched in­roads in the field this year.

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