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  "documentTitle": "Bristol-Myers Squibb Company (BMY)",
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  "authorName": "Starboard Value",
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  "presentationDate": "2019-03-18 00:00:00",
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  "notes": "Uses a side-by-side comparison structure to highlight strategic failure vs success.",
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      "text": "Merck has gone on to gain additional approvals for KEYTRUDA in first-line NSCLC, while Bristol-Myers has continued to struggle, and shareholders are still waiting for OPDIVO to break into first-line NSCLC",
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      "text": "This gamble resulted in COMPLETE FAILURE, and CHECKMATE-026 failed its first-line NSCLC study.",
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      "text": "Bristol-Myers and Merck began pursuit of approval within the lung cancer market - seen as immuno-therapies most lucrative opportunity. Non-small cell lung cancer (\"NSCLC\") is estimated to be 85% of the $16 billion lung cancer market.",
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      "text": "Merck's trial (KEYNOTE-189) only enrolled patients if they were shown to have high levels (i.e. 50% expression) of PD-L1, increasing the likelihood that the patients would react positively to the PD-1 inhibitor. KEYTRUDA's KEYNOTE-189 halved the risk of disease progression in previously untreated patients, and cut overall deaths by 40% compared to chemotherapy. The FDA approved KEYTRUDA in first-line lung cancer patients with high PD-L1 expression.",
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      "text": "Bristol-Myers designed its trial to target patients regardless of their cancer's level of PD-L1 expression in hopes of receiving first-mover advantage. This was a gamble that Bristol-Myers hoped would result in a superior label for OPDIVO over its competitors, if successful.",
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      "text": "We believe Bristol-Myers took a major gamble by designing the CHECKMATE-026 trial to target patients regardless of their cancer's level of PD-L1 expression. This backfired enormously.",
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      "kind": "quote",
      "text": "\"Keytruda will be the new standard of care in first line lung.\" - Bank of America, October 2016; \"...Sets Stage for Merck to Dominate NSCLC Market.\" - Credit Suisse, October 2016",
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      "text": "\"This data represented a worst-case scenario for Opdivo.\" - Sanford Bernstein, October 2016",
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      "text": "\"This data represented a worst-case scenario for Opdivo.\" — Sanford Bernstein, October 2016; \"Keytruda will be the new standard of care in first line lung.\" — Bank of America, October 2016; \"...Sets Stage for Merck to Dominate NSCLC Market.\" — Credit Suisse, October 2016",
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      "kind": "source-note",
      "text": "Source: Public company filings, Wall Street research, Jennifer Tung, et al. v. Bristol-Myers Squibb Company, et al. lawsuit, Bloomberg, Reuters.",
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      "text": "OPDIVO CHECKMATE-026 vs KEYTRUDA KEYNOTE-189",
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      "kind": "title",
      "text": "Where Did CHECKMATE-026 Go Wrong? (cont'd)",
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