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Top 10 best selling cancer drugs in 2023 | Top cancer drug makers | iPharmaCenter

Updated: May 12


RANK

COMPANY

REVENUES

1

Keytruda

$25.0 billion

2

Darzalex

$9.7 billion

3

Opdivo

$9.0 billion

4

Imbruvica

$6.9 billion

5

Revlimid

$ 6.0 billion

6

Tagrisso

$ 5.8 billion

7

Ibrance

$ 4.7 billion

8

Imfimzi

$ 4.2 billion

9

Xtandi

$ 4.2 billion

10

Perjeta

$ 4.0 billion


Best selling cancer drugs 2023, Keytruda revenues, Darzalex, Opdivo, Imbruvica, Revlimid revenues
Best selling cancer drugs 2023

1. KEYTRUDA

Revenues in 2023: $25 billion

Company: Merck & Co.


Approved Indications:

Keytruda is approved for several cancer types: Keytruda (pembrolizumab) has received approval for a range of indications. It is used in the treatment of melanoma in cases where the cancer is unresectable or metastatic. Additionally, it is prescribed for various stages of non-small cell lung cancer (NSCLC), including as a first-line therapy for tumors expressing high levels of PD-L1, as a monotherapy for disease progression post-platinum-containing chemotherapy, and in combination with chemotherapy. In head and neck squamous cell carcinoma (HNSCC), Keytruda is indicated for recurrent or metastatic disease after platinum-containing chemotherapy, and it can also be used in combination with platinum and fluorouracil (FU) chemotherapy. Moreover, Keytruda is recommended for classical Hodgkin lymphoma (cHL) in both adult and pediatric patients with relapsed or refractory disease. It's also approved for primary mediastinal large B-cell lymphoma (PMBCL) in adults with relapsed or refractory disease. Keytruda plays a role in the treatment of urothelial carcinoma, particularly for patients ineligible for cisplatin-containing chemotherapy and those with disease progression after prior chemotherapy. Furthermore, it is indicated for microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) cancers, including colorectal cancer with MSI-H or dMMR status post-progression on prior treatment. Additionally, Keytruda is used in gastric cancer and esophageal cancer for recurrent or metastatic tumors expressing PD-L1. Lastly, it is prescribed for cervical cancer in cases of recurrence or metastasis with PD-L1 expression after chemotherapy.


Mechanism of Action:

Keytruda is a PD-1 receptor blocker.

Here's how it works:

Normal Immune Response: T cells are activated and can attack tumor cells.

Tumor Evasion and T-cell Deactivation: Some tumors evade the immune system through the PD-1 pathway. PD-L1 and PD-L2 ligands on tumors bind with PD-1 receptors on T cells, inactivating them.

T-cell Reactivation with Keytruda: Keytruda binds to the PD-1 receptor, blocking its interaction with PD-L1 and PD-L2. This helps restore the immune response against cancer cells. Note that this reactivation could also affect normal healthy cells16.


What's working in its favor?:

The ongoing research and development efforts by Merck continue to propel its momentum. It has become the world's top-selling drug, surpassing long-standing leaders like Humira and Lipitor.


2. DARZALEX

Revenues: $9.7 billion

Company: Johnson & Johnson


Approved indications:

Approved for various stages of multiple myeloma, Darzalex has garnered widespread acclaim for its efficacy and versatility in patient care. Its approved indications span from newly diagnosed cases to relapsed or refractory disease, offering hope and tangible outcomes across the spectrum of this complex condition.


Mechanism of action:

The mechanism of action underlying Darzalex's success lies in its unique ability to target CD38, a surface protein abundantly expressed on multiple myeloma cells. By binding to CD38, Darzalex initiates a cascade of immune-mediated responses, including direct cellular toxicity, antibody-dependent cellular cytotoxicity, and complement-dependent cytotoxicity, ultimately leading to the eradication of malignant cells.


What's working in its favor?:

Darzalex's impact transcends traditional boundaries, with ongoing research exploring its potential in other hematological malignancies and solid tumors. From amyloidosis to lymphoma, Darzalex's versatility underscores its promise as a therapeutic agent with far-reaching implications for cancer treatment.

In addition to its clinical efficacy, Darzalex has redefined the standards of patient care with its favorable safety profile and convenient administration. As a testament to its significance, Darzalex has become an integral component of treatment regimens worldwide, offering newfound hope to patients and healthcare providers alike.


3. OPDIVO

Revenues: $ 9.0 billion

Company: BMS


Approved indications:

Opdivo has secured approvals across various malignancies, marking a significant milestone in cancer therapy. Its approved indications include melanoma, non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), classical Hodgkin lymphoma (cHL), squamous cell carcinoma of the head and neck (SCCHN), hepatocellular carcinoma (HCC), urothelial carcinoma, colorectal cancer, and esophageal squamous cell carcinoma.


Mechanism of action:

The mechanism of action of Opdivo centers around immune checkpoint inhibition, particularly targeting the programmed death-1 (PD-1) pathway. By blocking the interaction between PD-1 and its ligands, Opdivo unleashes the body's immune system to mount a robust antitumor response, effectively combating cancer cells.


What's working in its favor?:

The success of Opdivo extends beyond its approved indications, with ongoing research efforts exploring its potential in novel therapeutic settings. Clinical trials are underway to evaluate Opdivo's efficacy in various solid tumors and hematological malignancies, including but not limited to, small cell lung cancer, glioblastoma, and triple-negative breast cancer.


Furthermore, Opdivo's role in combination therapies has garnered significant interest, with studies investigating its synergistic effects when paired with other immunotherapies, targeted agents, or conventional chemotherapies.


4. IMBRUVICA

Revenues: $6.9 billion

Company: AbbVie and Janssen


Approved indications:

Approved for a spectrum of hematological malignancies, Imbruvica has earned widespread recognition for its efficacy and versatility in patient management. Its approved indications span across various diseases, including chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), Waldenström's macroglobulinemia (WM), marginal zone lymphoma (MZL), and chronic graft-versus-host disease (cGVHD), reflecting its broad impact on diverse patient populations.


Mechanism of action:

At the core of Imbruvica's success lies its unique mechanism of action, targeting Bruton's tyrosine kinase (BTK), a key mediator in B-cell signaling pathways. By inhibiting BTK, Imbruvica disrupts the survival and proliferation of malignant B-cells, leading to apoptosis and ultimately impeding tumor growth.


What's working in its favor?:

Imbruvica's efficacy extends beyond traditional boundaries, with ongoing research exploring its potential in combination therapies and novel disease settings. Imbruvica's favorable safety profile and convenient oral administration have transformed the treatment experience for patients, reducing the burden of frequent hospital visits and invasive procedures.

 

5. REVLIMID

Revenues: $ 6.0 billion

Company: BMS


Approved indications:

Approved indications for Revlimid include multiple myeloma (MM) and myelodysplastic syndromes (MDS). In MM, Revlimid is indicated for newly diagnosed patients as well as those with relapsed or refractory disease, either as a monotherapy or in combination with other agents. In MDS, Revlimid is indicated for specific subsets of patients with low- or intermediate-1 risk disease associated with a deletion 5q cytogenetic abnormality.


Mechanism of action:

The mechanism of action of Revlimid involves modulation of the immune system and inhibition of angiogenesis. It is an immunomodulatory agent that exerts its effects through multiple pathways, including enhancement of T cell- and NK cell-mediated immune responses, inhibition of pro-inflammatory cytokine production, and suppression of angiogenesis through inhibition of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF).


What's working in its favor?:

The success of Revlimid can also be attributed to ongoing research and development efforts aimed at expanding its indications and exploring its potential in other hematological malignancies and solid tumors. Clinical trials are underway to evaluate its efficacy in lymphoma, chronic lymphocytic leukemia (CLL), and solid tumors such as ovarian and prostate cancer, among others.


6. TAGRISSO

Revenues: $ 5.8 billion

Company: AstraZeneca


Approved indications:

Approved for the treatment of metastatic NSCLC with epidermal growth factor receptor (EGFR) mutations, particularly the T790M mutation, Tagrisso has garnered widespread acclaim for its efficacy and safety profile. Its approval has provided a lifeline for patients facing limited treatment options and has redefined the standard of care in EGFR-mutated NSCLC.


Mechanism of action:

The mechanism of action underlying Tagrisso's success lies in its potent inhibition of EGFR signaling pathways, specifically targeting mutant forms of the receptor. By selectively blocking aberrant EGFR signaling, Tagrisso effectively impedes tumor growth and progression, offering patients a chance at prolonged survival and improved quality of life.


What's working in its favor?:

Tagrisso's impact extends beyond its approved indications, with ongoing research exploring its potential in other EGFR-mutated malignancies and in combination with other targeted agents or immunotherapies. From adjuvant therapy in early-stage NSCLC to investigations in central nervous system metastases, Tagrisso continues to push the boundaries of cancer treatment.


In addition to its clinical efficacy, Tagrisso's favorable safety profile and convenient oral administration have transformed the treatment experience for patients, minimizing treatment-related toxicities and improving adherence to therapy.


7. IBRANCE

Revenues: $ 4.7 billion

Company: Pfizer


Approved indications:

Approved for use in combination with hormonal therapy, such as aromatase inhibitors or fulvestrant, Ibrance has garnered widespread acclaim for its efficacy and safety profile in the treatment of advanced breast cancer. Its approval has reshaped treatment paradigms, providing a potent weapon against metastatic disease and extending survival for patients facing a daunting diagnosis.


Mechanism of action:

At the heart of Ibrance's success lies its unique mechanism of action, targeting cyclin-dependent kinases 4 and 6 (CDK4/6), key regulators of the cell cycle. By inhibiting CDK4/6, Ibrance disrupts the uncontrolled proliferation of cancer cells, leading to cell cycle arrest and ultimately inhibiting tumor growth.


What's working in its favor?:  

Ibrance's impact extends beyond its approved indications, with ongoing research exploring its potential in other breast cancer subtypes and in combination with novel agents or immunotherapies. From early-stage hormone receptor-positive breast cancer to metastatic disease resistant to standard therapies, Ibrance continues to push the boundaries of breast cancer treatment.


8. IMFINZI

Revenues: $ 4.2 billion

Company: AstraZeneca


Approved indications:

Approved for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC), Imfinzi has emerged as a beacon of hope for patients facing advanced disease. By blocking the PD-L1 pathway, Imfinzi unleashes the body's immune system to mount a potent anti-tumor response, effectively combating cancer cells and slowing disease progression.


Mechanism of action:

The mechanism of action underlying Imfinzi's success lies in its ability to harness the power of the immune system to target and destroy cancer cells. By restoring the body's natural defenses against cancer, Imfinzi offers a promising option for patients who have exhausted standard treatment options and are in need of new therapeutic strategies.


What's working in its favor?:

Imfinzi's impact extends beyond NSCLC, with ongoing research exploring its potential in other types of cancer, including bladder cancer, head and neck cancer, and esophageal cancer, among others. From exploring new biomarkers to investigating combination therapies, Imfinzi continues to pave the way for innovative treatment approaches in oncology.


9. XTANDI

Revenues: $ 4.2 billion

Company: Astellas


Approved indications:

Approved for use in patients who have progressed on standard hormonal therapies, Xtandi has garnered widespread acclaim for its efficacy and safety profile in the treatment of mCRPC. By targeting androgen receptor signaling, Xtandi disrupts the growth and proliferation of cancer cells, leading to tumor regression and improved survival outcomes.


Mechanism of action:

The mechanism of action underlying Xtandi's success lies in its ability to inhibit the androgen receptor pathway, thereby blocking the signals that drive prostate cancer growth. By effectively depriving cancer cells of the hormones they need to thrive, Xtandi offers a potent and targeted approach to treatment, minimizing systemic side effects and maximizing therapeutic benefit.


What's working in its favor?:

Xtandi's impact extends beyond its approved indications, with ongoing research exploring its potential in earlier stages of prostate cancer and in combination with other agents or treatment modalities. From exploring new biomarkers to investigating combination therapies, Xtandi continues to push the boundaries of prostate cancer treatment, offering promise for improved outcomes and a brighter future for patients worldwide.


10. PERJETA  

Revenues: $ 4.0 billion

Company: Roche


Approved indications:

Approved for use in combination with other HER2-targeted agents and chemotherapy, Perjeta has garnered widespread acclaim for its efficacy and safety profile in both the early and metastatic settings of HER2-positive breast cancer. By targeting the HER2 receptor, Perjeta blocks the signals that drive cancer cell growth and proliferation, leading to tumor regression and improved survival outcomes. 


Mechanism of action:

The mechanism of action underlying Perjeta's success lies in its ability to complement the action of other HER2-targeted therapies, such as Herceptin, by binding to a different epitope on the HER2 receptor. This dual targeting approach maximizes the inhibition of HER2 signaling, effectively depriving cancer cells of the nutrients they need to thrive and proliferate.


What's working in its favor?:

Perjeta's impact extends beyond its approved indications, with ongoing research exploring its potential in other breast cancer subtypes and in combination with novel agents or treatment modalities. From exploring new biomarkers to investigating combination therapies, Perjeta continues to push the boundaries of breast cancer treatment, offering promise for improved outcomes and a brighter future for patients worldwide.

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