From the 29th of last month to the 2nd of this month, the American Society of Clinical Oncology (ASCO 2026) in Chicago drew more than 44,000 oncologists and pharmaceutical executives, befitting the world's largest cancer meeting. Each year, clinical data unveiled at this meeting resets standards of care and moves stock prices by trillions of won. This year was no exception. But the source of the shock was not what many expected.
◇ China's bispecific antibody takes center stage, threatening Keytruda's dominance
ASCO has a "Plenary Session," the most prestigious stage at the meeting, with only four to five studies chosen out of thousands. This year, the lung cancer drug "ivonescimab" from Chinese biotech Akeso made the cut. It was the first time in ASCO's history that a trial enrolling only patients from China was selected for this stage.
Ivonescimab is a bispecific antibody that combines two mechanisms in a single antibody. It both signals immune cells to attack cancer and blocks the blood vessels that tumors use to siphon nutrients. The industry has watched the drug as a next-generation contender to surpass Merck's Keytruda, which dominates the global oncology market.
The phase 3 (HARMONI-6) results unveiled at this ASCO beat market expectations. Among 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 control arm. Median overall survival (OS) was 27.9 months, exceeding the control arm's 23.7 months.
Summit Therapeutics, which holds global rights, also presented phase 2 results in metastatic colorectal cancer at the same venue (disease control rate 100%, objective response rate 70.8%). The day after the presentation, Akeso's shares on the Hong Kong stock market jumped as much as 12.3% intraday.
Still, some urged caution. Julie Brahmer of Johns Hopkins University noted the follow-up in the trial was only about two years, that patients 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 goes head-to-head; Korean corporations target the "unmet medical need" gap
While Chinese corporations opted to challenge existing standards of care head-on, Korean corporations chose to dig into areas with treatment gaps. Common targets are markets where current therapies have clear limits, such as post-Enhertu treatment (Voronoi), patients refractory to immunotherapy (GI Innovation), and metastatic pancreatic cancer (Onconic Therapeutics).
① Zeroing in on 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 Enhertu. They have no suitable follow-up options. Voronoi's "VRN10" aims squarely at that gap.
In interim phase 1a results involving 35 patients with HER2-positive or HER2-mutant solid tumors, the HER2-mutant cohort showed an objective response rate (ORR) of 43% and a disease control rate (DCR) of 86%. Among HER2-positive breast cancer patients previously treated with Enhertu, DCR was 83%, and partial responses (PR) were also observed in HER2-mutant lung cancer that progressed after Enhertu.
Even among patients with brain metastases, a notorious challenge in cancer care, an intracranial DCR of 75% was observed. Because the brain is a tissue that is difficult for drugs to penetrate, the industry sees this as a potential differentiator.
② After Keytruda failure, alongside Keytruda: GI Innovation's "GI-101A" combination phase 1
This was a particularly watched presentation among domestic corporations at this ASCO. It was selected for the "Rapid Oral" session, reserved for chosen studies, and was the only study in the immunocytokine field.
In end-stage solid tumor patients at the fourth-line setting who had failed all standard therapies, the recommended phase 2 dose (0.3 mg/kg) showed an ORR of 55% and a DCR of 82%. Considering typical fourth-line ORRs are around 10%–20%, the results are striking. Some patients maintained progression-free survival (PFS) for up to 22.3 months.
The key is that it suggested Keytruda could be reused in patients refractory to or relapsed after existing immunotherapies. The potential market is the 70% of all cancer patients who are refractory to or relapse after immunotherapy. The company said, "Right after the presentation, global pharmaceutical companies began booking additional meetings on site," noting 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 global trial median overall survival (OS) for the current standard gemcitabine plus nab-paclitaxel regimen is just 8.5 months.
In a phase 1b study of 27 patients with metastatic or advanced pancreatic cancer, the gemcitabine plus nab-paclitaxel combination arm showed an ORR of 53.8%, a DCR of 92.3%, and a median OS (mOS) of 14.2 months. That is about 1.7 times the existing standard (8.5 months). The most striking case was a patient with metastatic pancreatic cancer who achieved a complete response (no detectable cancer cells) and has now survived more than 40 months.
At the data cutoff, four patients were still on treatment without disease progression, so the median progression-free survival (PFS) remained "not reached." This indicates the numbers could improve further.
Kim Jon, CEO of Onconic Therapeutics, said, "Given the meaningful results in patients with KRAS mutations and in those without BRCA mutations, we will broaden global partnership talks to enhance the clinical and business value of Nesuparib."