NO.10 Eli Lilly
Eli Lilly is among the top 10 oncology drug giants and still relies on the old drug Alimta (pemetrexed), but Alimta fell in 2021 due to competition from generic drugs, with revenue of $2.061 billion (-11.5%). Cyramza (remoloxumab) performed modestly, and the breast cancer drug Verzenio (abexili) grew gradually to $1.35 billion, an increase of nearly 50%, which is the best growth potential of CDK4/6 products, but Pfizer's Ibrance (Pipersilier) still dominates the market.
Eli Lilly's acquisition of LOXO's oncology product Retvmo (RET inhibitor) will harvest $115 million in 2021, which is a significant increase but the market capacity is limited after all. Tyvyt(Sindili maclizumab), which works with Cinda, is only available in China, and this month the FDA's Advisory Committee on Oncology Drugs (ODAC) voted 14:1 to supplement new clinical studies to meet regulatory requirements for listing in the United States.
Overall, Eli Lilly does not have an advantage in product growth potential in the field of oncology, with the exception of Verzenio. The BTK C481S inhibitor pirtobrutinib may not be available until 2023, but the current advantages are also mainly concentrated in patient groups of second-line and above.
NO.9 AbbVie
Imbruvica (ibrate) and Venclexta (Venexta) are two of AbbVie's core products in the field of oncology and the pillar products that have established AbbVie's position in the field of oncology. Imbruvica will have revenues of $5.408 billion in 2021, but the growth trend has slowed, mainly due to increased market competition, among other reasons. As the first BTK inhibitor on the market, Imbruvica will not only face the competition of akatinib and zebutinib, but also meet the challenges of BTK C481S products, AbbVie has reused the strategy of settling Humira's patent lawsuit with generic drug manufacturers on Imbruvica to ensure that no Imbruvica generic products will enter the United States before March 30, 2032.
Venclexta is the world's first Bcl2 inhibitor to be marketed, growing 36% to $1.82 billion in 2021. AbbVie is also tapping into the market potential of Imbruvica+Venclexta combination therapy in oncology treatment, and is expected to seek first-line CLL indications in 2023, as well as accelerated approval of Venclexta monotherapy in high-risk MDS.
NO.8 Amgen
Amgen's revenue from the oncology business in 2021 is relatively stable, the proportion of business has not changed, and the product growth rate is relatively flat (2.0% vs 2.1%). The much-watched KRAS G12C inhibitor Sotorasib was approved for listing by the FDA at the end of May 2021, and was subsequently approved in Europe and Japan, but the half-year sales were only $90 million, which also directly led to the decline in Mirati Therapeutics' stock price that day.
Amgen's oncology business segment is still supported by older products such as Xgeva (denosumab), Kyprolis (carfezomib) and tumor biosimilars Mvasi (bevacizumab), Vectibix (Panizumab) and Kanjinti (trastuzumab), which together bring $5.737 billion to Amgen.
NO.7 Pfizer
The sharp decline in revenue from Pfizer's oncology business was mainly due to the huge increase in the company from the COVID-19 vaccine Comirnaty and the oral COVID-19 drug Paxlovid, which combined to exceed $36.8 billion.
In the field of oncology, Pfizer relies most on its core product, Ibrance, and despite achieving revenue of $5.4 billion, the growth trend has almost stagnated (+1%), and its share in the CDK4/6 market is being captured by Eli Lilly and Novartis. Pfizer, which has money in its hands, naturally cannot tolerate others sleeping soundly. In July 2021, it received a global interest in ARV-471 with an advance payment of $650 million and a milestone payment of $1.4 billion. Aiming to combine ARV-471 and Ibrance for breast cancer treatment, it will raise its own competitive barriers. Preclinical data show that ARV-471 and Ibrance do have a significant synergistic effect, which can effectively reduce tumor growth. Clinical studies of ARV-471 monotherapy or combined Ibrance have already begun in 2019 (NCT04072952) and preliminary data are expected to be seen in 2022.
NO.6 AstraZeneca
AstraZeneca's total revenue for 2021 was $37.417 billion and its oncology business reached $13.66 billion, with Tagrisso (oshitinib), Imfinzi (duvalliumab), Lynparza (Olaparizumab), Calquence (akatinib) and Enhertu directly contributing $11.63 billion.
In terms of specific products, Tagrisso (osimerinib), Imfinzi (duvalliumab), Lynparza (Olaparizumab) have an absolute advantage, but the growth rate of the 3 drugs has begun to slow down, but Calquence (akatinib) has achieved 137% growth compared with 2020, reaching $1.238 billion in revenue; Enhertu has become a new growth pole for AstraZeneca, with the same high proportion of growth in 2021 (123%) growth (123%). to $214 million, and the market potential has not been fully tapped.
In the field of oncology, AstraZeneca will lay out the two major directions of tumor "killing" and "immunity", increase cooperation and development of innovative products, including expanding the therapeutic potential of marketed products, and accelerating the development of clinical products Wee1 inhibitors adavosertib, camizestrant, ADC (Her2/Trop2) and new mechanism (protac).
Enhertu, in particular, is expected to become AstraZeneca's new oncology blockbuster. In 2022, Enhertu's indications for second-line Her2-positive breast cancer will usher in regulatory decisions in the first half of the year, which is expected to change the current treatment pattern after approval; recently, Enhertu has shown a trend of OS benefit in patients with low-expression Her2 unresectable and/or metastatic breast cancer, as well as the benefit potential previously shown in Patients with Her2 expression, or will change the mode of treatment of disease markers. Of course, enhertu's market advantage will be further expanded.
In addition, Tagrisso, Imfinzi+/-tremelimumab, Lynparza and other drugs will not stop the pace of indication expansion, TROP2 ADC drugs Such as Dato-DXd and antisense therapy eplontersen will also submit initial marketing applications.
NO.5 Johnson & Johnson
Johnson & Johnson's oncology business revenue was $14.55 billion in 2021, accounting for 27.9% of its entire pharmaceutical business segment. Darzalex (daritolumab) and Imbruvica (ibrate) performed steadily and were the two flagship products of Johnson & Johnson's oncology business. Among them, Darzalex (daritolumab) increased by 43.8%, showing strong market potential, while the slowing growth of the Imbruvaica (ibutinib) market, the two varieties together contributed nearly $10.4 billion in revenue to Johnson & Johnson, which is crucial to establish Johnson & Johnson's market position in the field of oncology.
Sales of the generic drug Zytiga (abiteron) fell 7 percent, but still had nearly $2.3 billion in revenue; Erleada also reached $1.3 billion, although the newly launched EGFR/c-MET bispecific antibody Rybrevant (Amivantamab) did not disclose sales figures. Johnson & Johnson plans to establish an optimal combination around Rybrevant for all treatment lines of EGFR mutation NSCLC, including combination chemotherapy for EGFR ex20ins first-line treatment, combination chemotherapy and lazirtib (third-generation TKI) second-line treatment of pan-EFGR mutations, and first-line treatment of pan-EGFR mutations in combination with lazirtib.
NO.4 Novartis
Novartis' oncology business in 2021 performed well, reaching $15.48 billion, accounting for 30.0% of the total revenue of its pharmaceutical business. However, on the whole, the lack of bright spots, mainly the lack of influential blockbuster products, the year-on-year growth rate of the tumor business is also 5.2% single digits.
After imatinib fell off the patent cliff, Novartis had a large number of tumor products on the market, including the CDK4/6 inhibitor Kisqali (ribociclib), the PI3Kα inhibitor Piqray (alpelisib), the c-Met inhibitor Tabrecta (carmatinib) and the CAR T product Kymriah (tisagenlecleucel), but it did not occupy an absolute advantage in the field competition. The CDK4/6 inhibitor field is still the dominant Pfizer, and Eli Lilly is also catching up, but Kissali is still stable; the CAR-T field is still the leading sales of Aquilon Race, and the product matrix is constantly strengthening.
At present, Novartis' highest sales in the field of oncology is still the Tasigna (nilotinib), which was listed in 2007, which was stable and rising, followed by the Tafinlar + Mekinist combination, which brought Novartis $1.693 billion in revenue. In terms of innovative products, the c-Met inhibitor Tabrecta (carmatinib) sold only $90 million in its first year.
NO.3 Merck
Merck's pharmaceutical business revenue in 2021 was $42.754 billion, and Keytruda and its cooperative products Lynparza (Olapari) and Lenvima (lunvatinib) constituted the main camp of the oncology business, totaling $18.879 billion. Keytruda continues to penetrate and maintain a large market advantage in key cancers such as NSCLC, triple-negative breast cancer, kidney cell carcinoma, head and neck squamous cell carcinoma, MSH-I, etc., and still maintains a high growth rate of nearly $17.2 billion in revenue, and is expected to exceed $20 billion in 2022.
Lynparza (Olapally) and Lenvima (Lenvatinib) despite being a joint product, AstraZeneca also received nearly $1.7 billion in sales revenue. However, Merck also occupies a place in the field of oncology mainly with Keytruda, and the growth momentum of subsequent products is difficult to sustain. In addition, after K drug covers almost all possible indications, the pace of clinical trial expansion has also slowed down. Therefore, Merck may follow in the footsteps of AbbVie, and there are long-term concerns in the field of tumors that rely heavily on individual drugs.
NO.2 Roche
In 2021, Roche's pharmaceutical business generated REVENUE OF CHF 45.041 billion (approximately US$49.496 billion) and the proportion of the oncology business was 45.4%, totaling CHF 20.467 billion (approximately US$22.491 billion). Although the old "troika" Avastin, Herceptin, and Rituxan were affected by the impact of biosimilars and led to a decline in sales, the volume advantage as a tumor drug giant is still there, which also enables Roche to continue to retain the revenue advantage of the tumor business.
Nevertheless, compared with the revenue of the oncology business in 2020, Roche failed to reverse the downward trend in 2021. Avastin (bevacizumab), Herceptin (trastuzumab) and Rituxan (rituximab) fell by 38%, 37% and 28% respectively, totaling only 7.749 billion Swiss francs (about $8.5 billion), a decrease of almost 4.2 billion Swiss francs compared to 2020; Perjeta (paltozumab) was the highest selling product in the oncology business, achieving sales revenue of 3.95 billion Swiss francs, a slight increase (+4%), Tecentriq (+24%), kadcyla (+16%), and Alecensa (+18%) also maintained good growth rates, but the growth trend seems to be slowing down.
However, Tecentriq was also approved as the first PD-1/L1 product in the field of adjuvant therapy for lung cancer in 2021, and is expected to generate incremental revenue in 2022. In December 2021, Roche orally reported at the ESMO-IO Conference the latest results of the Phase II CITYSCAPE study of tiragolumab + attilizumab (TIGIT+PD-L1) vs atenizumab for the first-line treatment of PD-L1-positive metastatic NSCLC, which reduced the risk of disease exacerbation or death by 38% in ITT populations and 71% in patients with high expression of PD-L1. The next step in the TIGIT+PD-L1 combination is also a matter of concern.
NO.1 Bristol-Myers Squibb
In 2021, BMS is still at the top of the tumor business sales rankings, mainly after the acquisition of Celgene to obtain drug supplements. Drugs such as Revlimid (lenalidomide), Opdivo (navuliyumab), Pomalyst (pomalidomide), Sprycel (dasatinib), Yervoy (epilimumab), Abraxane (albumin paclitaxel) and other drugs have combined to generate more than $30.1 billion.
Revlimid (lenalidomide) sales revenue in 2021 is close to $13 billion, but in 2022 has lost market exclusivity, recently Novartis company Sandoz has announced that it will launch Revlimid (lenalidomide) generic drugs in 19 European countries, and Revlimid sales are expected to decrease by about $3 billion in 2022.
Can bring bMS obvious growth momentum should still be the benchmark product Opdivo, even if 2021 suffered from the second-line hepatocellular carcinoma and second-line lung cancer indications withdrawal of bad news, but from the results of Opdivo to achieve positive growth, reverse the downward momentum in 2020, revenue reached 7.523 billion US dollars, an increase of 8%.
Although O drugs can be expected, BMS also needs to focus on cultivating other new generation blockbuster products in addition to O drugs. Breyanzi is a CD19 CAR-T cell therapy launched by BMS in February 2021, and even though the performance in the first year was not satisfactory, it was also highly expected by BMS to be one of the five drugs that will provide an important contribution to BMS sales in the next two years. In addition, LAG-3 antibody development BMS also showed a leading posture, and in 2021, the data of THE PHASE II/III trial of relaylimab +Opdivo (LAG3+PD1) for the treatment of metastatic or non-resectable melanoma were released, confirming that the fixed dose of linearityb+ nivolumab was more effective than Opdivo monotherapy. At the same time, we are actively expanding new cooperation to introduce new products, including the TIGIT bispecific antibody project with Agenus, the introduction of FRα ADC drugs from Eisai and the development of SHP2 small molecule projects; the development of iPSC-derived allogeneic cell therapies with Century; and the development of tumor and immunomodulatory drugs in cooperation with AI-driven pharmaceutical company Exscientia.