Adam Lenkowsky
Analyst · your question.
Thank you, Carter. To start, let me just say, we're very pleased with what we're seeing across our cell therapy franchise. Now for Abecma, as David mentioned, year-on-year we grew approximately 50%. There are a few factors that impacted the second quarter for Abecma. The quarter-on-quarter decline was driven mainly by pricing dynamics in Germany. Second, there was a planned impact due to manufacturing maintenance that happened in June in anticipation of our KarMMa-3 approval, which we expect in the back end of the year, we would also anticipate a significant increase in volume in the fourth quarter. And thirdly, we anticipate an increase in the use of other BCMA agents in the US. And we know this is a competitive market. But it's a market that we know extremely well, and we're very confident in our ability to compete in myeloma with this important product Abecma. I think most importantly, we continue to see and hear from physicians about favorable perceptions for Abecma based on our durable responses in a real-world setting, as well as high manufacturing success rates, now that are north of 90%. So taken together, we do remain very confident about Abecma's outlook in the second half of 2023 and beyond. The second question was around Opdualag. And so, for Opdualag, as you heard from David, Opdualag is rapidly becoming the standard of care in the US. We're continuing to see strong growth in sales, our share in first-line metastatic melanoma is approaching 25%. And our share is coming both from PD-1 monotherapy and from Opdivo-Yervoy combination. But now two-thirds of that share is being sourced from PD-1 monotherapy, roughly 50-50 from Opdivo and KEYTRUDA. As we talked about last quarter, NCCN updated their guidelines and changed Opdualag from category 2A to category 1 in BF-mutant patient population, and it removed BRAC Nec [ph] inhibitors as a preferred treatment in the first line setting. So as a result, we're seeing a really nice inflection in the BF-mutant patient population for both Opdualag and for Opdivo-Yervoy, and that's why we're continuing to focus our efforts on that segment. So in fact, when I think about the total DMS share in the overall metastatic melanoma market, our share -- if you look at Opdualag, Opdivo-Yervoy and Opdivo monotherapy, our share is now greater than 55%. So I'm very proud of our continued leadership in metastatic melanoma.