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FDA OKs Merck drug, 1st in new cancer drug class

LINDA A. JOHNSON
AP Business Writer

TRENTON, N.J. (AP) — Merck & Co. on Thursday won the first U.S. approval for a new kind of cancer drug with big advantages over chemotherapy and other older cancer treatments.

The Food and Drug Administration said it has granted accelerated approval to Merck’s Keytruda, for treating melanoma that’s spread or can’t be surgically removed, in patients previously treated with another melanoma drug called Yervoy.

Experts called the news “game-changing” for patients with the deadly skin cancer, which is becoming more common and kills nearly 10,000 Americans each year.

Keytruda, a genetically engineered drug known chemically as pembrolizumab, is part of a hot, promising new class of antibody-based drugs. They work by taking a brake off the immune system so it can better recognize and attack cancer cells.

“Ninety percent of patients have basically no side effects,” Dr. Antoni Ribas, a researcher and professor at UCLA’s Jonsson Comprehensive Cancer Center who was the lead investigator of a crucial study of Keytruda, told The Associated Press in an interview.

By comparison, most patients getting chemotherapy suffer with nausea, vomiting and hair loss.

In addition, Ribas said, Keytruda and other “immune-therapy” drugs appear likely to work against many more types of cancer than older drugs, and in a much higher percentage of patients.

In a study funded by Merck, which is based in Whitehouse Station, New Jersey, one-third of the 600 patients participating benefited from the drug, with 62 percent of those alive after 18 months.

Chemotherapy drugs have an average survival of about nine months, while some newer cancer drugs on average keep patients alive for 11 to 15 months, noted Ribas, who serves as an adviser to Merck but said he donates all payments to UCLA.

“This is just the start,” Ribas said, adding that earlier tries at immune therapy for cancer typically helped only 5 percent to 10 percent of patients.

The average overall survival rate for Keytruda hasn’t been determined yet, as most patients in the study are still being followed.

Merck’s drug is the first in the class of what’s called anti-PD-1 drugs approved in the U.S.

“This drug represents a major step forward,” Dr. Louis M. Weiner, a spokesman for the American Association for Cancer Research, said in a statement. “It is an effective immunotherapy (but) not a general immune stimulant. It attacks a specific mechanism employed by some cancers to actively evade immune destruction.”

Bristol-Myers Squibb Co. and a partner have a drug similar to Keytruda, called Opdivo, which was approved in Japan in July. They are seeking U.S. approval for it.

Merck said Keytruda will cost about $12,500 per month for many patients — similar to the price of many other new cancer drugs — and on average treatment lasts for just over six months.

The drug did have serious, immune-related side effects in a small number of patients, including hepatitis, colitis, thyroid problems and kidney inflammation. It’s administered every three weeks through a slow intravenous drip — until the cancer progresses or the patient has intolerable side effects.

One study participant, 49-year-old Rich Murphy of Marshfield, Massachusetts, said that after about five rounds of treatment with Keytruda in 2012, he stopped taking medicines and was still cancer-free at his latest checkup 2 ½ months ago.

“I owe my life to that drug. There’s no question about it,” Murphy, a real estate agent, said in an interview.

He had about 15 melanoma tumors under the skin throughout his torso, and after being diagnosed in 2008, underwent multiple rounds of radiation and surgery, plus chemotherapy. He then took Bristol-Myers’ Yervoy, but it stopped working after several months.

Once he started on Keytruda, Murphy said, the only side effect he had was dry skin.

Tim Turnham, executive director of the Melanoma Research Foundation, called Keytruda’s approval “a tremendous step forward for the melanoma patient community.”

“This is the most promising and positive patient response to a melanoma treatment to date,” he said in a statement, but cautioned that it won’t work in all late-stage melanoma patients — the goal of ongoing research.

Merck, Bristol-Myers and rivals including Astra-Zeneca PLC and the Roche Group all are running multiple studies of anti-PD-1 drugs, used alone or in combination with other medicines, for treating a variety of cancers. Those include head and neck cancer, bladder and gastric cancers and non-small cell lung cancer, as well as advanced melanoma.

In after-hours trading, Merck shares rose 22 cents to $60.30. They had dipped 40 cents in regular trading as the broader markets all declined.

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Follow Linda A. Johnson at www.twitter.com/LindaJ_onPharma

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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