2025 Q1: Oncology Business Competition Among MNCs

Recently, several multinational corporations (MNCs) released their financial reports for Q1 2025. Amid mounting pressures and a rapidly evolving market landscape, their performances continue to diverge. Nevertheless, the oncology field remains a cornerstone business for most MNCs. So, how did MNCs fare in the oncology field during Q1 of this year?

Merck

In Q1 2025, Merck reported global sales of USD 15.5 billion, representing a 2% year-over-year decline. Revenue from its pharmaceutical business reached USD 13.638 billion - accounting for 88% of total sales - down 3% compared with the same period last year. This decline was primarily driven by weaker performance in its vaccine and antiviral products. Despite fluctuations in performance, its revenue from the oncology field continued to grow, led by the strong performance of its flagship PD-1 inhibitor, Keytruda (pembrolizumab).

Keytruda generated USD 7.205 billion in sales during Q1, with a YoY increase of 4% and contributed 53% of the total pharmaceutical business revenue. In the United States market, the performance growth of Keytruda was largely driven by expanded use in adjuvant and neoadjuvant therapy for non-small cell lung cancer (NSCLC), as well as its indication for advanced urothelial carcinoma. Outside the United States, Keytruda's growth was supported by increasing demand in adjuvant and neoadjuvant therapy of Triple Negative Breast Cancer (TNBC) and kidney cancer, as well as the demand for metastatic indications.

Since 2021, early-stage tumor indications in adjuvant and neoadjuvant therapy have emerged as a new battleground for PD-1 inhibitors. In clinical studies on triple-negative breast cancer (TNBC), Keytruda has delivered impressive results in both adjuvant and neoadjuvant therapy. Results from the KEYNOTE-522 study demonstrated that, with a median follow-up of 39.1 months, Keytruda plus chemotherapy showed a significant improvement in event-free survival (EFS) compared with chemotherapy alone, with a hazard ratio (HR) of 0.63 (95% CI: 0.48-0.82; P=0.00031).

Based on the favorable results of this study, the FDA, European Medicines Agency (EMA), and National Medical Products Administration (NMPA) have approved pembrolizumab in combination with chemotherapy for neoadjuvant therapy followed by adjuvant treatment in patients with high-risk early-stage TNBC.

In the field of NSCLC, Keytruda has also demonstrated strong clinical efficacy. According to data from the Phase III KEYNOTE-091 test, among patients who had undergone surgical resection followed by platinum-based adjuvant chemotherapy, Keytruda reduced the risk of disease recurrence or death by 27% compared with the placebo group. For the primary endpoint of disease-free survival (DFS), the median DFS was 58.7 months in the Keytruda group, compared with just 23.8 months in the placebo group.

Merck has projected that by 2028, sales from Keytruda's adjuvant and neoadjuvant therapy indications could make up 30% of the total, which highlights the substantial potential of the early-stage cancer treatment field.

Among other antitumor drugs, Merck's oral hypoxia-inducible factor-2 alpha (HIF-2α) inhibitor Welireg (belzutifan) was approved by the EU on February 19 this year for the treatment of von Hippel-Lindau (VHL) disease-associated tumors. It is the first HIF-2α inhibitor approved for marketing and had previously been approved in multiple countries and regions, including the United States, the United Kingdom, and Canada. In Q1, Welireg generated USD 137 million in sales, with a YoY increase of 62%.

Additionally, Merck reported revenues of USD 321 million from Lynparza (olaparib), a PARP inhibitor co-developed with AstraZeneca; USD 258 million from Lenvima (lenvatinib), in collaboration with Eisai; and USD 119 million from Reblozyl (luspatercept), developed in partnership with Bristol Myers Squibb (BMS).

In terms of pipeline progress, the perioperative treatment with Keytruda (pembrolizumab) combination therapy for locally advanced head and neck squamous cell carcinoma (HNSCC) has received FDA Priority Review designation, with a PDUFA date set for June 23, 2025.

Additionally, Merck released initial data from a Phase III test of the subcutaneous formulation of Keytruda in Q1. The results demonstrated that subcutaneous Keytruda, administered with hyaluronidase alpha (MK-3475A), was non-inferior in efficacy and safety to the intravenous dosage as a first-line treatment for metastatic NSCLC. The PDUFA target date is set for September 23, 2025.

Merck has initiated a Phase III clinical test of its ROR1 antibody-drug conjugate (ADC) new drug, Zilovertamab Vedotin, for the treatment of DLBCL. The drug was acquired through Merck's USD 2.75 billion acquisition of VelosBio in 2020.

Roche

In Q1 2025, Roche reported revenues of CHF 15.44 billion, with a YoY increase of 6%. Revenue from the Pharmaceuticals Division reached CHF 11.949 billion, with a YoY increase of 8%. The revenue from the oncology field grew by 2% YoY, primarily driven by the HER2 product portfolio - including Phesgo, Perjeta, and Kadcyla - as well as the Atezolizumab (Tecentriq).

Phesgo is a subcutaneous compound formulation injection composed of Trastuzumab, Pertuzumab, and hyaluronidase, indicated for the treatment of early and metastatic HER2+ breast cancer. Compared with traditional intravenous administration, Phesgo shortens administration time by 90-95% - from approximately 150 minutes to just 5 minutes - significantly improving patient compliance. In Q1 of this year, Phesgo generated CHF 593 million in sales, with a YoY increase of 52%.

Perjeta (Pertuzumab) is a recombinant humanized monoclonal antibody targeting HER2. It is approved for use in combination with trastuzumab and chemotherapy as adjuvant treatment for HER2+ early breast cancer, neoadjuvant therapy for patients with HER2+, locally advanced, inflammatory, or early-stage breast cancer (tumor size >2 cm or node-positive), and for the treatment of HER2+, metastatic or unresectable locally recurrent breast cancer. In Q1, Perjeta generated CHF 840 million in sales, with a YoY decrease of 10%.

Kadcyla (ado-trastuzumab emtansine) is a HER2-targeted ADC composed of the humanized IgG1 monoclonal antibody trastuzumab linked to the cytotoxic agent DM1 via a non-cleavable MCC linker. It is approved for second-line treatment and adjuvant treatment of early and metastatic HER2+ breast cancer. In Q1, Kadcyla generated CHF 506 million in sales, with a YoY increase of 5%.

Tecentriq is a monoclonal antibody targeting PD-L1. It has been approved globally for the treatment of multiple cancers, including non-small cell lung cancer (NSCLC), small cell lung carcinoma (SCLC), hepatocellular carcinoma, urothelial carcinoma, PD-L1-positive metastatic triple-negative breast cancer (TNBC), and advanced melanoma with BRAF V600 mutations. In Q1, Tecentriq generated CHF 870 million in revenue, with no YoY change.

In terms of pipeline development, Roche has initiated a Phase III trial evaluating the anti-TIGIT monoclonal antibody tiragolumab in combination with Tecentriq for the treatment of locally advanced esophageal cancer.

AstraZeneca

In Q1, AstraZeneca reported total revenue of USD 13.588 billion, with a YoY increase of 10%. Performance in the oncology field was primarily driven by Tagrisso (osimertinib), Imfinzi (durvalumab), and Enhertu (trastuzumab deruxtecan).

Tagrisso is a third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) that effectively targets both sensitizing EGFR mutations (such as exon 19 deletions and L858R) and the resistance mutation T790M. It also demonstrates strong blood-brain barrier penetration. As the first third-generation EGFR-TKI approved globally, Tagrisso is considered the benchmark drug in its class. Currently, the indications of Tagrisso are approved across the full treatment continuum for lung cancer, including first-line, second-line, and adjuvant treatment settings. In Q1 of this year, Tagrisso generated USD 1.679 billion in revenue, with a YoY increase of 8%.

Imfinzi is a PD-L1 inhibitor that works by blocking the interaction between PD-L1 on tumor cells and the PD-1 receptor on T cells, thereby relieving immunosuppressive signaling and reactivating T-cell-mediated cytotoxicity against cancer cells. Imfinzi has established itself as a benchmark in perioperative immunotherapy for indications such as NSCLC and cholangiocarcinoma. In March 2025, it was approved by the FDA for use in combination with gemcitabine and cisplatin as a perioperative treatment for adult patients with muscle-invasive bladder cancer (MIBC). In Q1, Imfinzi generated USD 1.261 billion in revenue, with a YoY increase of 16%.

Enhertu (HER2-ADC) developed by Daiichi Sankyo and AstraZeneca is a flagship product that has been approved for multiple indications, including second-line treatment of HER2+ breast cancer, HER2-low breast cancer, locally advanced or metastatic HER2+ gastric or gastroesophageal junction adenocarcinoma, and locally advanced or metastatic NSCLC. In Q1, the global sales of Enhertu totaled USD 1.086 billion, including revenue from regions managed by Daiichi Sankyo.

Lynparza (olaparib) is a first-in-class PARP inhibitor and the first approved synthetic lethality-based targeted therapeutic drug. It is designed to target cells and tumors with homology-directed repair (HRR) deficiencies, such as those harboring BRCA1 and/or BRCA2 mutations. Lynparza has been approved in the United States, the EU, Japan, and many other countries and regions for the treatment of gBRCAm and HER2- high-risk early breast cancer, among other indications. In Q1, Lynparza generated USD 726 million in sales, with a YoY increase of 5%.

Calquence (acalabrutinib) is a Bruton's tyrosine kinase (BTK) inhibitor that has been approved for the treatment of various hematologic tumors. In Q1, Calquence generated USD 762 million in revenue, with a YoY increase of 8%.

Bristol Myers Squibb (BMS)

In Q1, Bristol Myers Squibb (BMS) reported total revenue of USD 11.2 billion, with a YoY decrease of 6%. In the oncology field, Opdivo (nivolumab) and Opdualag (nivolumab + relatlimab) were the main contributors to revenue.

Opdivo is a PD-1 immune checkpoint inhibitor designed to counter tumor-induced immune suppression and restore the body's anti-tumor immune response. In Q1, Opdivo generated USD 2.265 billion in revenue, with a YoY increase of 9%.

Opdualag is the first approved combination therapy targeting both PD-1 and LAG-3 pathways. In March 2022, Opdualag was approved by the FDA for the treatment of adults and pediatric patients aged 12 years and older with unresectable or metastatic melanoma. By targeting two immune checkpoint pathways, Opdualag enhances T-cell activity to strengthen the anti-tumor response. In Q1, Opdualag generated USD 624 million in revenue, with a YoY increase of 7%.

The second oral KRAS G12C inhibitor, Krazati (adagrasib), of Bristol Myers Squibb (BMS), generated USD 48 million in revenue in Q1, with a YoY increase of 125%. The drug features a long half-life of up to 24 hours, broad tissue distribution, and the ability to penetrate the blood-brain barrier, all of which help maximize its therapeutic potency. Krazati received accelerated approval from the FDA at the end of 2022 for the treatment of previously treated patients with KRAS G12C-mutation NSCLC. Notably, Krazati was originally developed by Mirati Therapeutics. In October 2023, Bristol Myers Squibb (BMS) acquired Mirati in a USD 4.8 billion deal, securing the rights to this therapy.

Bristol Myers Squibb (BMS)’s traditional chemotherapy drug Abraxane (nab-paclitaxel) generated USD 105 million in revenue in Q1, marking a YoY decline of 52%.

Oncology field, as a major therapeutic area, remains a fiercely competitive and strategically vital battleground. In this ever-evolving landscape, pharmaceutical giants continue to push forward, driving innovation and advancement in tumor treatment through intense competition and relentless pursuit of leadership.

References:

1. Financial Reports of Pharmaceutical Companies in Q1 2025

2.https://www.merck.com/news/welireg-belzutifan-receives-first-european-commission-approval-for-two-indications/.

3.https://www.astrazeneca.com/media-centre/press-releases/2025/imfinzi-recommended-for-eu-approval-for-ls-sclc.html.

4.https://www.businesswire.com/news/home/20250117223765/en.