Issue #95·

A lung cancer drug just cut the risk of death by 34%. The catch? It's complicated.

ASCO 2026 is delivering the kind of data that makes oncologists spill their coffee. A bispecific antibody outperformed the king of immunotherapy in lung cancer, a pancreatic cancer drug doubled survival for the first time ever, and BioNTech decided to burn its pandemic empire to the ground. Buckle up.

Top Story Today

The Drug That Took a Swing at the King of Immunotherapy

Keytruda has been unbeatable in lung cancer for years. That streak just got its biggest scare. At the ASCO plenary session, Akeso and Summit Therapeutics showed that ivonescimab, a bispecific antibody that blocks both PD-1 and VEGF simultaneously, cut the risk of death by 34% in first-line squamous NSCLC. Two-year survival hit 64.7%, compared to 48.6% for a standard PD-1 combo. But the comparator wasn't Keytruda itself. Wall Street wanted a bigger absolute survival gap, and regulators will want Western data.

Why it matters: This is the first time any PD-1/VEGF bispecific has shown a statistically significant survival advantage over a PD-1 inhibitor in lung cancer, validating the entire drug class and putting Keytruda's dominance on notice, even if geography and comparator questions will shape the regulatory path forward.

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ASCO Blockbusters

The Drug That Just Doubled Pancreatic Cancer Survival

Pancreatic cancer has resisted meaningful progress for decades. Revolution Medicines' daraxonrasib just shattered that wall: median survival of 13.2 months versus 6.7 on chemo, a 60% reduction in death risk. The FDA authorized an early access program before approval, and the company is already shipping the drug to patients. Analysts see a potential $10 billion opportunity.

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BMS and Pfizer Both Came Out Swinging on ASCO's Opening Day

BMS's next-gen myeloma drug mezigdomide hit a statistically significant win in relapsed patients, building out the CELMoD franchise. Meanwhile, Pfizer's lorlatinib posted seven-year follow-up showing 55% of ALK-positive lung cancer patients still progression-free. In metastatic cancer, measuring survival in years instead of months is almost unheard of.

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Merck's ADC Just Notched a First in Endometrial Cancer

Women with advanced endometrial cancer who'd exhausted chemo and immunotherapy had no targeted therapy that could beat standard chemo. Merck's sac-TMT just became the first ADC to do it, hitting both overall survival and PFS endpoints in a global Phase 3 trial of 776 patients. Full data are expected later this year; for now, it's a key pillar in Merck's post-Keytruda strategy.

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Deals and Dealmaking

Lilly's Quiet Bet on a Gut Hormone You've Never Heard Of

Eli Lilly licensed a long-acting GLP-2 drug from Hanmi Pharma for up to $1.26 billion, targeting short bowel syndrome. The pitch: replacing daily injections with one shot per month. Preclinical data show a 70x longer half-life than the current standard. No human efficacy data yet, but Lilly paid just $75 million upfront to secure the option.

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Lilly Bets $3 Billion on Five Mystery Programs from a Chinese Drugmaker

Eli Lilly signed a $3 billion deal with China's Haisco Pharmaceutical covering five undisclosed drug programs. The upfront payment was just $87 million; the rest is milestones. Neither company revealed targets, diseases, or timelines. It's another node in Lilly's sprawling external innovation strategy, funded by Zepbound and Mounjaro cash.

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Industry Shakeups

BioNTech Just Torched Its Pandemic Empire. On Purpose.

BioNTech is shutting four manufacturing sites, cutting 1,860 jobs (22% of its workforce), and handing COVID vaccine production to Pfizer. The company that once made a billion doses a year is exiting manufacturing entirely to fund an oncology pivot backed by 25-plus clinical trials and a 17.2 billion euro cash pile. The bet: cancer drugs will be worth more than pandemic infrastructure.

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