Keytruda: Merck's Oncology Juggernaut

Merck's Keytruda, unsurprisingly remaining the clear-cut leading oncology drug, has shown exceptional growth, with a 16% YoY growth. Keytruda’s sales rose by $1B to $7.3B. Keytruda now boasts 40 indications in the US alone, showcasing its significant versatility and impact across various cancer types.

AstraZeneca: A Beacon in Oncology

AstraZeneca stands out with four medicines among the biggest sellers, more than any other company. Oncology is a critical pillar for AstraZeneca, underscored by its ambitious revenue target of $80 billion by 2030 announced during its May 2024 investor day. This target is up from their ~$46B target announced last year.

Tagrisso: Advancing Lung Cancer Treatment

Tagrisso, a leading medicine from AstraZeneca, demonstrated impressive outcomes in the Phase III LAURA trial. The findings, shared at ASCO in June, showed an 84% decrease in the risk of disease progression or death in Stage III lung cancer patients when compared to placebo. This positions Tagrisso on the brink of approvals for all stages of EGFR-mutated non-small cell lung cancer, with interim analyses already indicating its overall survival benefits. Tagrisso also benefits from patent protection in the US until 2032.

Enhertu: Pioneering ADC Therapies

Enhertu, AstraZeneca and Daiichi Sankyo’s ADC, has been breaking ground as the first tumor-agnostic approval of a HER2-directed therapy. On August 19th, the FDA granted Enhertu its eighth Breakthrough Therapy Designation for patients with HER2 low or HER2 ultralow metastatic breast cancer. This review, spurred by the DESTINY-Breast06 trial results presented at this year’s ASCO congress, will further expand the addressable patient population. The company expects to exceed 100,000 in the US, EU5, and Japan by 2026.

Enhertu has six promising additional indications it could add in the next three years, including four for various breast cancers (2025-2026), one for NSCLC (2025), and one for metastatic gastric cancer (2026). Enhertu benefits from patent protection in the US and the EU until 2033, which underscores its promising future.

Verzenio: A Key Contributor

Although overshadowed by its GLP-1s, Verzenio has been an important contributor to Eli Lilly’s performance this quarter as it continues to grow in the breast cancer treatment market. Despite the discontinuation of the Phase 3 CYCLONE-3 trial evaluating Verzenio for prostate cancer treatment, Verzenio has achieved significant growth YoY.

The Competitive Landscape of Oncology

Oncology remains at the forefront of BioPharma, with significant investments in research and development driving progress and innovation. The sector's leading medicines, such as Keytruda, Tagrisso, and Enhertu, not only highlight the industry's financial potential but also its profound impact on patient care. Despite the robust sales growth of these medications, a persistent challenge in oncology is the trend towards highly specific treatments. While this ensures patients receive more targeted medicines, it also means that the potential market for each approved treatment is quite small, which can slow down the overall growth in sales.