"China is eating our lunch."Robert Kennedy Jr., U.S. Minister of Health and Welfare, during an April congressional hearing
From on the 29th to on the 2nd in Chicago, the American Society of Clinical Oncology (ASCO 2026), the world's largest cancer conference, drew more than 44,000 oncologists and pharmaceutical officials. Every year, clinical data unveiled at this meeting change standards of care in cancer and move stock prices worth trillions of won. This year was no exception. But the epicenter of the shock differed from expectations.
◇ China's bispecific antibody drug dominates the top stage, threatening Keytruda's stronghold
ASCO has a "Plenary Session." It is the most prestigious presentation stage across the meeting, with only four to five selected out of thousands of studies. This year, that slot went to Akeso, a Chinese biotech, for its lung cancer drug "ivonescimab." It was the first time in ASCO history that a study enrolling patients only in China was selected for this stage.
Ivonescimab is a bispecific antibody that combines two mechanisms in one antibody. It sends signals to immune cells to attack cancer while blocking the blood vessels through which tumors siphon nutrients. The industry has watched it as a next-generation contender to surpass Keytruda from Merck, which currently dominates the global oncology market.
The phase 3 (HARMONI-6) results unveiled at this ASCO exceeded market expectations. In patients with advanced squamous non-small cell lung cancer (NSCLC), the risk of death in the ivonescimab plus chemotherapy arm was 34% lower than in the comparison arm. Median overall survival (OS) was 27.9 months, above the comparison arm's 23.7 months.
Summit Therapeutics, which holds global rights, also presented phase 2 data in metastatic colorectal cancer at the same venue (disease control rate 100%, objective response rate 70.8%). The day after the presentation, Akeso's share price on the Hong Kong stock exchange jumped as much as 12.3% intraday.
Caution, however, was also raised. Julie Brahmer of Johns Hopkins University noted that the follow-up in the study was only about two years, that people 75 and older and women were scarcely included, and that differences in patient characteristics and treatment environments between China and the United States make simple comparisons difficult. The FDA will decide on ivonescimab's approval in Nov.
◇ China's head-on challenge; Korean corporations target the gap in "unmet medical needs"
While Chinese corporations chose to go head-to-head against existing standard therapies, Korean corporations opted to dig into areas where treatment gaps remain. Markets with clear limits to current therapies are the common targets, such as post-Enhertu treatment (Voronoi), patients unresponsive to immunotherapy (GI Innovation), and metastatic pancreatic cancer (Onconic Therapeutics).
① Taking aim at the "post-Enhertu" market: Voronoi's "VRN10" phase 1a
The current powerhouse in HER2-positive cancer treatment is "Enhertu," an Antibody-Drug Conjugate (ADC) co-developed by AstraZeneca and Daiichi Sankyo. The problem is patients whose cancer grows back even after treatment with Enhertu. They have no suitable subsequent treatment options. Voronoi's "VRN10" targets that very gap.
In the interim results of a phase 1a study in 35 people with HER2-positive or HER2-mutant solid tumors, the objective response rate (ORR) was 43% and the disease control rate (DCR) was 86% in the HER2-mutant cohort. Among people with HER2-positive breast cancer previously treated with Enhertu, DCR was 83%, and partial response (PR) was also confirmed in HER2-mutant lung cancer that progressed after Enhertu.
In people with brain metastases, a major challenge in cancer care, the intracranial DCR was 75%. Because the brain is a tissue that is difficult for drugs to penetrate, the industry says this could be a differentiator going forward.
② Even after Keytruda failure, and together with Keytruda: GI Innovation's "GI-101A" combination phase 1
This was the presentation that drew particular attention among domestic corporations at this ASCO. It was selected for the "Rapid Oral" session, reserved only for chosen studies, and was the only study in the immunocytokine field.
Among terminal solid tumor patients in the fourth-line setting who failed all standard treatments, at the recommended phase 2 dose (0.3 mg/kg), ORR was 55% and DCR was 82%. Considering that ORR for fourth-line therapies typically runs 10% to 20%, the results are striking. A case maintaining progression-free survival (PFS) for up to 22.3 months was also confirmed.
The key is that it suggested Keytruda could be used again in people who are unresponsive to or relapse after prior immunotherapy. People unresponsive to or relapsing after immunotherapy, who make up as much as 70% of all cancer patients, are the potential market. The company said, "Right after the presentation, global pharmaceutical companies began scheduling additional meetings on site," adding that the technology transfer process has entered its final phase.
③ Taking on pancreatic cancer with no options: Onconic Therapeutics' "Nesuparib" phase 1b
Pancreatic cancer is the toughest wall to clear in oncology trials. Once it metastasizes, survival drops sharply, and the median overall survival (OS) for the global trial of the current standard regimen, gemcitabine plus nab-paclitaxel, is only 8.5 months.
In a phase 1b study in 27 people with metastatic or advanced pancreatic cancer, the combination with nab-paclitaxel showed ORR 53.8%, DCR 92.3%, and median OS (mOS) 14.2 months. That is about 1.7 times the current standard (8.5 months). The most striking case was a person with metastatic pancreatic cancer who achieved complete response (a state in which cancer cells have completely disappeared) and has now survived more than 40 months.
At the time of data cutoff, four people were continuing treatment without disease progression, so the median progression-free survival (PFS) was "not reached." This means there is still room for the numbers to improve.
Kim Jon, CEO of Onconic Therapeutics, said, "Because we saw meaningful results in KRAS-mutant patients and in patients without BRCA mutations, we will expand global collaboration discussions to enhance the clinical and business value of Nesuparib."