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“You come at the king, you best not miss.”
— Omar Little in “The Wire”

Keytruda is the immunotherapy king. In the U.S., the Merck anti-PD1 checkpoint inhibitor is approved to treat 16 cancers and has 26 indications overall. Sales were $11 billion in 2019 and $6.7 billion through the first half of this year. Keytruda is not only the most successful cancer drug ever developed, but it ranks among the best medicines ever.

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That hasn’t stopped competitors from taking shots at it. A big part of this year’s annual meeting of the European Society for Medical Oncology, which concluded yesterday, involved data presentations from rival drug makers trying to show their medicines can stand up to Keytruda. None of these are direct, head-to-head clinical trials — don’t hold your breath for those being done — but all of the studies still involve Keytruda because it’s the real-world measuring stick.

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