Nivolumab

There are countless diseases lacking a single good treatment, but drugmakers are still herding into the same targets, particularly in chasing after megablockbusters. George Yancopoulos, the outspoken co-founder and chief scientific officer of Regeneron, is one of the loudest critics of this trend. “Even if they make something you take twice as less frequently, is that what they should be doing?” he said in an interview. “Give me a new drug that treats a new disease.” Herding isn’t new, but it has gotten worse. Only 16% of top drugmakers’ portfolios were in crowded targets in 2000, a percentage that quadrupled by 2020, a McKinsey analysis found . The last few years have only brought more attention to a handful of programs that have pipeline-in-a-product opportunity like Keytruda, Dupixent and Ozempic. Yancopoulos is very aware that Regeneron’s successor plans for Dupixent feature the same target as its best-selling antibody. He said that the Dupixent follow-on research is “not the thing I’m proudest of,” but Regeneron is doing so “out of necessity.” There’s an extended half-life IL-13 antibody and an IL-4/IL-13 bispecific antibody, which could be dosed less frequently than Dupixent. But more importantly to investors, they could protect that franchise from aspiring rival products from biotechs like Apogee Therapeutics and Kymera Therapeutics. “My whole goal is to get the resources to do as much as we can with the best scientists we can,” he told Endpoints News on the sidelines of the JP Morgan Healthcare Conference. “I don’t want some bozos who are going to buy luxury yachts to take investment dollars into R&D that belong to us.” To be sure, it’s a self-interested argument for the company that co-developed Dupixent with Sanofi. Regeneron’s stock fell 9% over last week, with investors concerned about how the biotech will follow up its success with Dupixent and the eye drug Eylea. Markets for obesity and cancer are even more dramatic examples of the crowding. “Welcome to the party,” Eli Lilly CEO David Ricks said during his company’s JPM presentation, responding to an analyst question about future competition on GLP-1s and beyond. Ricks said he believes the “competition makes us better,” planning to win the race with its own pipeline. Meanwhile, Summit Therapeutics is ahead in a race that has exploded for drugs co-targeting PD-1 and VEGF. The company, co-led by the iconoclastic billionaire Bob Duggan and Maky Zanganeh, blasted into the industry’s consciousness in 2024, touting that a late-stage head-to-head study of its drug beat Keytruda in certain lung cancer patients. The next 18 months saw Summit go from relatively alone in pursuing PD-1/VEGF to dozens of biopharmas joining the fray. In 2022, Summit in-licensed its drug, called ivonescimab, from China-based Akeso, which continues to sell the drug in China. Pfizer, Merck, BioNTech and most recently AbbVie have also since in-licensed their own PD-1xVEGF programs from China. “They can’t replicate the insight and the courage to do this,” Duggan said in an interview. “They cannot duplicate ivo as it stands. Carbon, oxygen, hydrogen, nitrogen, sulfur: They can duplicate that, but not the way it’s all laid out. And that’s special.” Summit and Akeso’s drug stands apart by having already treated thousands of patients, Zanganeh added. Combined, they have enrolled 4,000 patients in trials and Akeso has dosed over 60,000 commercial patients in China, Zanganeh said. Summit recently filed for its first US approval, expecting a decision later in 2026. “None of these companies right now, I don’t believe they enroll more than hundreds of patients,” Zanganeh said. The market is mulling that argument. Summit’s stock fell 14% over last week. Some Wall Street analysts are skeptical over the company’s $12.7 billion valuation and if its lead is insurmountable, given far larger and more experienced drugmakers are seeking to catch up. Leerink analyst Daina Graybosch, who holds an underperform rating on Summit, wrote last week there are “few (if any) large-cap pharma companies with sufficient capital and interest to provide upfront consideration for ivo that support [Summit’s] current valuation.” Biopharma execs are split if zeroing in on the same targets is the best use of R&D budgets. Proponents point to the statin race in the 1980s, where Lipitor — the fifth statin to market — ultimately became the class’ bestseller. More recently, Merck’s Keytruda was second to market behind Bristol Myers Squibb’s Opdivo, but has since dominated. Jin-Long Chen, a former Amgen executive who is now a managing partner at Bay Area-based biotech investment group TCG Labs, said it often varies depending on the target and program. He pointed to Keytruda as an example of the real value for latecomers. But as markets become more and more crowded, that argument grows tougher. “That’s not black and white, but if you’re number 10 in targeting the same mechanism, you’re wasting your life,” Chen said.