The disputes in the oncology field are endless, and in this arena full of challenges and opportunities, major pharmaceutical giants are showcasing their full capabilities. Some are striving to catch up, others are overtaking on curves, and some are sticking to their positions. Together, they are writing a grand story of industry competition.
Compared to the business landscape of 2023, new changes and disruptions are unfolding: AstraZeneca, with its carefully constructed lung and breast cancer product portfolio, has surpassed Johnson & Johnson and moved up in rankings; Pfizer's costly acquisition of Seagen is showing results, and it has gained the position originally held by Novartis with an advantage of around 1 billion USD.
In the competition for the top three positions, Merck, with the best-selling oncology drug Keytruda, has successfully defended its position. However, Merck faces a “sweet burden” as it must both defend the territory it has gained with Keytruda and accelerate the development of new products to fill the potential patent cliff in the future. Meanwhile, the competition between BMS and Roche is intensifying. Through the diversification of both solid tumor and hematologic oncology segments, both companies' oncology business revenues have grown to the scale of 27 billion USD.
The fierce competition among these giants, although full of conflict and uncertainty, is pushing the entire oncology field forward. Each breakthrough and innovation brings more hope of "cure" to cancer patients and opens up broader life pathways.
In 2024, AbbVie's oncology performance rebounded, with total revenue reaching 6.555 billion USD, a 10.8% year-over-year increase. This was due to the growth of products such as Venclexta, Elahere, and Epkinly, which offset the negative impact from declining sales of Imbruvica.
Imbruvica, a classic BTK inhibitor co-developed by AbbVie and Johnson & Johnson, was once the best-selling leukemia drug globally, with sales reaching nearly 9.8 billion USD in 2021. However, with the iteration of drug development, Imbruvica has faced intense market competition. In 2024, its global revenue dropped to 6.385 billion USD. Additionally, due to U.S. Medicare price negotiations, AbbVie expects Imbruvica’s future sales to be further impacted.
On the other hand, AbbVie's blood cancer blockbuster product, the Bcl-2 inhibitor Venclexta, has shown stable growth with sales reaching 2.583 billion USD (+12.9%). The new product Epkinly, a CD3/CD20 bispecific antibody, was approved by the FDA in May 2023 and generated 146 million USD in revenue in 2024. Additionally, Elahere, a new FRα ADC drug acquired from ImmunoGen for 10.1 billion USD, generated 479 million USD in 2024.
In 2024, AbbVie also entered into collaborations with EvolveImmune, Sientra, and Neomorph to develop emerging anti-cancer therapies such as multispecific antibodies and molecular glues. Going forward, AbbVie's oncology research directions will include apoptosis, tumor immunity, ADCs, PROTACs, and CAR-T therapies.
Eli Lilly's oncology business, driven by its core product Verzenio, reached a total revenue of 8.752 billion USD, with a strong 31% growth. Potential products such as Tyvyt and Retevmo continued to perform well, each achieving more than 30% growth. Jaypirca, a new product, also performed well in its first year on the market.
In 2024, Verzenio sales surpassed 5 billion USD (+37%), overtaking Pfizer’s Ibrance to become the new leader in the CDK4/6 inhibitor space. This was mainly due to Verzenio's successful expansion of indications to early-stage breast cancer, creating a new market.
Tyvyt, a PD-1 monoclonal antibody co-developed by Eli Lilly and Innovent, brought in 526 million USD in 2024, a 34% year-over-year growth. Retevmo, the world’s first approved selective RET inhibitor, reached 364 million USD in sales, growing 44%. In 2024, Retevmo also expanded into indications for RET fusion-positive solid tumors and medullary thyroid cancer.
Jaypirca, approved in 2023, is a first-in-class non-covalent BTK C481S inhibitor that overcomes resistance caused by the C481 mutation. In its second year on the market, it generated 337 million USD in sales. Additionally, classic anti-cancer drugs like Alimta, Erbitux, and Cyramza contributed nearly 1.8 billion USD in revenue.
Eli Lilly also has several promising new drugs in critical clinical trials, including the selective estrogen receptor degrader imlunestrant and the KRAS inhibitor olomorasib. Recently, Eli Lilly also acquired Scorpion Therapeutics' small molecule PI3Kα inhibitor STX-478 for 2.5 billion USD to strengthen its breast cancer product lineup.
Oncology is Amgen's second-largest business segment, and the long-listed CD3/CD19 bispecific antibody Blincyto remains the core driver of its growth, with 2024 sales increasing by 41% to 1.216 billion USD. The global first KRAS G12C inhibitor Lumakras/Lumykras (sotorasib) still has a relatively small market, with 2024 sales of 350 million USD. The key to expanding its market will depend on whether it can successfully enter first-line treatments for non-small cell lung cancer and colorectal cancer.
Notably, Imdelltra (tarlatamab), the world’s first CD3/DLL3 bispecific antibody, has made significant strides in small cell lung cancer, generating 115 million USD in sales in just half a year after launch. It is expected to become a major growth engine for Amgen. The success of Tarlatamab has also stimulated the development of DLL3-targeted therapies, indirectly leading to multiple business development deals between Roche and Innovent, IDEAYA Biosciences and HengRui, and Daiichi Sankyo and Merck.
Amgen has disclosed that the results of two Phase III studies for its potential first FGFR2 monoclonal antibody bemarituzumab in first-line gastric cancer treatment will be released later this year. Additionally, the biosimilar of nivolumab, ABP 206, is expected to have Phase III results in the second half of this year.
Novartis' oncology business continued to maintain steady growth in 2024, driven by CDK4/6 inhibitor Kisqali and two radioligand therapies.
The breast cancer drug Kisqali has consistently maintained double-digit growth since its launch, reaching sales of $3.033 billion (+49%) in 2024. Kisqali also secured two additional indications in the U.S. for earlier-stage HR+/HER2- breast cancer patients, providing a new growth opportunity. Novartis predicts the peak sales of Kisqali could exceed $8 billion.
The two radioligand therapies brought in $2.116 billion in revenue. Among them, Pluvicto surpassed $1 billion in sales for the first time in 2024, achieving a 42% growth. Novartis has also submitted a market application for Pluvicto in China and invested approximately 600 million RMB to establish a radiopharmaceutical production facility, preparing for future product launches. Another radioligand therapy, Lutathera, also performed well, with sales of $724 million, a 20% increase.
Notably, Novartis' new drug for chronic myeloid leukemia (CML), Scemblix, achieved $689 million in sales, a 68% increase. This drug is the first FDA-approved allosteric inhibitor that binds to the ABL myristoyl pocket. In October 2024, Scemblix was further approved for first-line treatment, building on its previous third-line treatment approval. Novartis considers Scemblix a blockbuster product with sales potential of $3 billion to $8 billion.
In 2024, Novartis also acquired MorphoSys for $2.9 billion and radiopharmaceutical company Mariana Oncology for $1.75 billion, further strengthening its oncology and drug pipeline. In the future, Novartis will continue to implement its existing strategies, focusing on chemical and biological therapies, RNA therapies, radioligand therapies, gene and cell therapy technologies.
In 2024, Pfizer's oncology business generated $15.612 billion in revenue, a 25% increase. The main drivers were androgen receptor signaling inhibitor Xtandi (enzalutamide), PARP inhibitor Talzenna (talazoparib), ALK inhibitor Lorbrena (lorlatinib), and the products acquired through the Seagen acquisition.
The Seagen acquisition rapidly enriched Pfizer’s oncology portfolio, including Nectin-4 ADC drug Padcev (venetoclax), CD30 ADC drug Adcetris (brentuximab vedotin), tissue factor (TF) ADC drug Tivdak, and HER2 inhibitor Tukysa (tucatinib), which together generated more than $3.2 billion in sales in 2024. Pfizer previously estimated that the revenue generated by the Seagen acquisition would reach $10 billion by 2030.
However, Pfizer faced challenges in oncology, as its key product Ibrance (palbociclib), the market leader for CDK4/6 inhibitors, lost significant market share. In 2024, Ibrance generated $4.367 billion, a decrease of 8% compared to the previous year.
In response, Pfizer is committed to rebuilding its oncology competitiveness. The appointment of Jeffrey Legos, M.D., as Chief Oncology Officer marks a critical step in this process. Prior to joining Pfizer, Dr. Legos served as Executive Vice President and Global Head of Oncology and Hematology Development at Novartis.
Johnson & Johnson's oncology revenue grew by 17.7%, largely driven by products like Darzalex (daratumumab), Erleada (apalutamide), Carvykti (ciltacabtagene autoleucel), and Tecvayli (teclistamab).
The company has established a leading position in the multiple myeloma space with its rich portfolio of monoclonal antibodies (mAbs), bispecific antibodies (bsAbs), and CAR-T therapies. Darzalex, a CD38 monoclonal antibody, generated $11.67 billion in 2024, a 19.8% increase, marking the first time the drug surpassed $10 billion in sales since its launch in 2015.
In partnership with Legend Biotech, Carvykti, a BCMA CAR-T therapy, brought in nearly $1 billion globally, marking a 92.7% growth. The continued explosive growth over the past two years has helped Carvykti stand out among CAR-T therapies. With increasing production capacity and expanded indications, Carvykti is expected to see even greater growth in the future.
For prostate cancer, the androgen receptor inhibitor Erleada saw strong growth since its launch in 2018, with sales reaching $2.999 billion (+25.6%) in 2024.
Johnson & Johnson's new generation products, the EGFR/c-Met bispecific antibody Rybrevant (ebastuzumab) and EGFR T790M inhibitor, achieved major breakthroughs in 2024, receiving FDA approval for use as a first-line, non-chemotherapy treatment for EGFR ex19del or L858R mutated NSCLC patients. The company sees significant market potential for this combination and expects peak sales to exceed $5 billion.
In 2024, Johnson & Johnson also completed the acquisition of ADC company Ambrx for $2 billion to enhance its oncology pipeline.
In 2024, AstraZeneca's oncology revenue surpassed Johnson & Johnson's, securing a higher rank. Its core products, such as Tagrisso (osimertinib), Imfinzi (durvalumab), Lynparza (olaparib), Calquence (acalbrutinib), and Enhertu (fam-trastuzumab deruxtecan), continued to show strong growth, contributing to overall performance improvement.
Tagrisso, the first third-generation EGFR-TKI approved globally, continued to maintain double-digit growth even after 10 years on the market. In 2024, sales reached $6.58 billion. The drug also expanded its indications in 2024 to include EGFR ex19del or L858R mutated locally advanced NSCLC and stage III EGFR-mutant NSCLC.
PD-L1 inhibitor Imfinzi, PARP inhibitor Lynparza, and BTK inhibitor Calquence also performed well, each achieving over 20% growth. Imfinzi expanded its indications to include endometrial cancer, perioperative treatment for early-stage NSCLC, and limited-stage small cell lung cancer (LS-SCLC).
AstraZeneca's ADC product Enhertu, developed in partnership with Daiichi Sankyo, generated $3.754 billion in sales, a 46% increase, ranking first in market share among similar products. Enhertu has expanded its indications to include HER2-positive, HER2-low, and HER2 ultra-low expression breast cancer. In addition, its second ADC product, Datroway (deruxtecan), has been approved in Japan and the U.S.
Another potential blockbuster for AstraZeneca is its AKT inhibitor Truqap (capivasertib), which generated $430 million in its first year on the market. Going forward, AstraZeneca will continue to focus on immuno-oncology therapies, ADCs, epigenetics, and cell therapies.
With the dual drivers of solid tumor and hematologic tumor segments, Roche's glory as an oncology leader shines again. In 2024, Roche's oncology business revenue reached CHF 23.744 billion (approximately $27.04 billion), bringing it close to the performance of BMS in the oncology field.
Tecentriq (atezolizumab) and Perjeta (pertuzumab) remain Roche's two flagship products in the solid tumor field. Among Roche's solid tumor products, the HER2 monoclonal antibody combination drug Phesgo (pertuzumab and trastuzumab subcutaneous injection) showed significant growth, increasing by 62% to CHF 1.74 billion (approximately $1.982 billion). Additionally, the approval of the PI3Kα inhibitor Itovebi has injected new vitality into Roche's breast cancer product line.
Roche, continuing to lead the breast cancer field, is strengthening its advantage through external innovation. In September 2024, Roche's Genentech will acquire the next-generation CDK inhibitor from Rigel Pharmaceuticals for $850 million, forming a more comprehensive product matrix with Roche's existing HER2, PI3K, and other targeted drugs.
In the hematology field, the CD79b ADC drug Polivy, which revolutionized the first-line treatment of diffuse large B-cell lymphoma (DLBCL), has shown strong product power, with sales of CHF 1.121 billion (approximately $1.277 billion), entering the ranks of blockbuster drugs. Two CD3/CD20 bispecific antibodies, Columvi and Lunsumio, which target different indications, are still in the ramp-up phase.
The development of universal CAR-T therapies is expected to further strengthen Roche's position in hematologic tumors. In November 2024, Roche acquired Poseida Therapeutics for $1.5 billion. Roche believes that universal CAR-T therapies based on Poseida's technology platform have the potential to become best-in-class products in various therapeutic areas.
BMS's oncology business is vast, with solid tumors and hematologic tumors advancing simultaneously. Opdivo (nivolumab) remains BMS's flagship product in the solid tumor field, generating $9.304 billion in sales in 2024, a 3% increase. In the competition with Keytruda, Opdivo's sales performance lags slightly behind, but it has gained significant ground, such as being the first PD-1 inhibitor to launch a subcutaneous formulation.
BMS has always been at the forefront of immuno-oncology combinations. Yervoy (ipilimumab) had steady growth, and the O + Y combination therapy received new indications in 2024, including first-line treatment for MSI-H/dMMR colorectal cancer patients in China. The PD-1 + LAG-3 combination therapy Opdualag (nivolumab + relatlimab) is one step away from becoming a blockbuster.
New generation ROS1/NTRK inhibitor Augtyro (repotrectinib) and the second global KRAS G12C inhibitor Krazati (adagrasib) are showing early promise, with 2024 global sales of $38 million and $126 million, respectively.
In the later-stage solid tumor pipeline, the anti-fucosyl-GM1 monoclonal antibody atigotatug (BMS-986012) embodies BMS's ambition to target small-cell lung cancer, with its Phase III trial for first-line combination therapy with Opdivo in extensive-stage small-cell lung cancer already underway.
In the hematology field, the CD19 CAR-T therapy Breyanzi saw sales surge to $747 million due to increased production capacity. The BCMA CAR-T therapy Abecma saw a decline in sales, reaching $406 million. The first-in-class erythropoiesis-stimulating agent Reblozyl (luspatercept) generated $1.773 billion in sales, driven by demand from anemia patients with myelodysplastic syndromes (MDS) in first-line treatment. The two generations of immunomodulatory drugs, Revlimid (lenalidomide) and Pomalyst/Imnovid (pomalidomide), contributed a combined $9.318 billion in sales.
In the future, BMS will focus on multiple myeloma in the hematology field. Its precisely targeted GPRC5D CAR-T therapy arlo-cel and two molecular glues, iberdomide and mezigdomide, are already in Phase III trials.
Merck's global oncology immunotherapy leader Keytruda (pembrolizumab) once again demonstrates its "king of drugs" strength, achieving $29.482 billion in sales in 2024, growing 18%. This accounts for 46% of Merck's total revenue and solidifies its position as the No. 1 oncology company.
Before the patent cliff arrives, Keytruda's sustained growth has become a certainty. This is mainly due to Merck's far-reaching strategic layout, which surpasses its competitors, ranging from the coverage of late-stage indications to early-stage explorations, from monotherapy to combinations, and the development of subcutaneous formulations. For early-stage cancer treatment, Keytruda is the only immunotherapy to show significant overall survival (OS) benefits in four studies and has received approval for 9 indications.
Other oncology products are also showing growth. The global first-in-class HIF-2α inhibitor Welireg, launched in 2021, has entered a rapid growth phase, achieving $509 million in sales in 2024, up 133%. Lynparza (olaparib) and Lenvima (lenvatinib) brought in $1.311 billion and $1.010 billion in revenue, respectively.
Based on its current business layout, Merck sees a $25 billion potential market opportunity in oncology. To convert this potential into actual revenue, ADC drugs will play a key role. Through collaborations with ADC leaders like Daiichi Sankyo and Kymab, Merck has rapidly acquired a series of promising pipeline products targeting HER3, B7-H3, CDH6, and TROP2. Among them, HER3-DXd has already been submitted for regulatory approval.
