Top 10 Selling Cancer Drugs of 2024

By Editorial Team
  1. Keytruda - $29.5 billion
  2. Darzalex - $9 billion
  3. Opdivo - $7 billion
  4. Imbruvica - $5billion
  5. Tagrisso - $5 billion
  6. Revlimid - $4 billion
  7. Verzenio - $4 billion
  8. Imfinzi - $4 billion
  9. Ibrance - $3 billion
  10. Tecentriq - $3 billion
In the rapidly evolving field of oncology, several cancer drugs have become best-sellers due to their proven effectiveness against various cancer types. Below, we examine some of the top-selling cancer drugs, highlighting their FDA-approved indications, mechanisms of action, and sales figures.

1. Keytruda (Pembrolizumab) - $29.5 billion

Indications Approved by FDA:
    • Non-small cell lung cancer (NSCLC)
    • Melanoma
    • Head and neck squamous cell carcinoma (HNSCC)
    • Classical Hodgkin lymphoma
    • Urothelial carcinoma
    • Gastric cancer
    • Esophageal cancer
    • Triple-negative breast cancer (TNBC)
    • Renal cell carcinoma (RCC)
    • Microsatellite instability-high (MSI-H) cancers
    • Colorectal cancer
    • Hepatocellular carcinoma (HCC)
    • Cervical cancer
Mechanism of Action: Keytruda is a monoclonal antibody that targets the programmed death-1 (PD-1) receptor on T cells. By binding to PD-1, it prevents the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which are often overexpressed on cancer cells. This blockade reactivates T cells, allowing them to recognize and attack cancer cells.

Company: Merck & Co.
2023 sales: $25 billion
2024 sales: $29.5 billion

In 2024, Keytruda’s sales grew 18% at constant exchange rates, reaching $29.5 billion. After AbbVie's Humira lost U.S. market exclusivity and as demand for COVID vaccines plummeted at the end of the pandemic, Merck & Co.’s Keytruda was finally able to claim the title of the world’s bestselling medicine in 2023. 

2. Darzalex (Daratumumab) - $11.6 billion

Indication Approved by FDA: Multiple myeloma and light chain amyloidosis.

Mechanism of Action: Darzalex is a monoclonal antibody that targets CD38, a glycoprotein expressed on the surface of multiple myeloma cells. By binding to CD38, Darzalex induces tumor cell death through multiple mechanisms, including complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and antibody-dependent cellular phagocytosis. It also modulates the immune system to attack the cancer cells.

Company: Johnson & Johnson
2023 sales: $9.7 billion
2024 sales: $11.6 billion

The Darzalex franchise, including the subcutaneous formulation Darzalex Faspro, was Johnson & Johnson’s second-largest brand last year. With $9.74 billion in global sales, the multiple myeloma drug accounted for 11.4% of the pharma and medtech giant’s total revenue haul for the year. 

Darzalex secured its initial FDA approval in 2015 as a fourth-line multiple myeloma treatment and the first monoclonal antibody for the blood cancer. It entered the first-line setting in 2018 as part of a now outdated combination including Takeda’s Velcade, the alkylating agent melphalan and the corticosteroid prednisone.   

Much more recently, the J&J drug has shown promise as part of an advanced combo with Velcade, Bristol Myers Squibb’s Revlimid and the steroid dexamethasone (VRd). Late last year, the Darzalex-containing four-drug regimen showed it could slash the risk of progression or death by 58% versus VRd alone in first-line myeloma patients who’re eligible for stem cell transplants. The company filed that combo with the FDA in January and secured a priority review. 

3. Opdivo (Nivolumab) - $7 billion

Indications Approved by FDA:
  • NSCLC
  • Melanoma
  • RCC
  • HNSCC
  • Urothelial carcinoma
  • Classical Hodgkin lymphoma
  • Hepatocellular carcinoma
  • Esophageal squamous cell carcinoma
  • Gastric cancer
  • Colorectal cancer with MSI-H/dMMR
  • Small cell lung cancer (SCLC)
Mechanism of Action: Opdivo is another immune checkpoint inhibitor that targets the PD-1 receptor on T cells. Like Keytruda, it blocks the PD-1/PD-L1 interaction, enhancing the immune system's ability to recognize and destroy cancer cells.

Companies: Bristol Myers Squibb and Ono Pharmaceutical
2023 sales: $10 billion
2024 sales: $9.3 billion

Bristol Myers Squibb (BMY) and Ono Pharmaceutical’s Opdivo, a treatment for melanoma and other cancers, generated $9.3 billion in global sales. In 2024, the melanoma-fighting medication alone accounted for nearly 20% of the company’s $48.3 billion in annual revenue.

Opdivo generated $10 billion in global sales last year, with $9 billion going to Bristol Myers Squibb and 148 billion Japanese yen ($1 billion) going to Ono Pharmaceutical.

4. Tagrisso (Osimertinib) - $5 billion

Indications Approved by FDA: 
  • EGFR T790M mutation-positive NSCLC
  • First-line treatment of metastatic NSCLC with EGFR exon 19 deletions or exon 21 L858R mutations
Mechanism of Action: Tagrisso is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). It selectively inhibits both EGFR sensitizing mutations and the T790M resistance mutation, which is a common cause of resistance to earlier-generation EGFR TKIs. By blocking these mutations, Tagrisso inhibits cancer cell proliferation and induces apoptosis.

5. Revlimid (Lenalidomide) - $5 billion

Indications Approved by FDA:
  • Multiple myeloma
  • Mantle cell lymphoma
  • Myelodysplastic syndromes (MDS)
  • Follicular lymphoma
Mechanism of Action: Revlimid is an immunomodulatory drug that has multiple mechanisms of action, including direct anti-proliferative effects on tumor cells, inhibition of angiogenesis, and immune system modulation. It also enhances T-cell and natural killer (NK) cell-mediated cytotoxicity and reduces the production of pro-inflammatory cytokines.

6. Verzenio (Abemaciclib) - $4 billion

Indications Approved by FDA: HR-positive, HER2-negative advanced or metastatic breast cancer

Mechanism of Action: Verzenio is an oral, selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6). By inhibiting CDK4/6, Verzenio prevents the phosphorylation of the retinoblastoma protein (Rb), leading to cell cycle arrest at the G1 phase, thereby inhibiting the proliferation of cancer cells.

7. Imfinzi (Durvalumab) - $4 billion

Indications Approved by FDA:
  • Unresectable stage III NSCLC
  • Extensive-stage small cell lung cancer (ES-SCLC)
  • Urothelial carcinoma
Mechanism of Action: Imfinzi is a monoclonal antibody that targets PD-L1, a ligand for PD-1. By binding to PD-L1, Imfinzi prevents it from interacting with PD-1 on T cells, thereby restoring immune responses and allowing the immune system to attack the cancer.

8. Ibrance (Palbociclib) - $4 billion

Indications Approved by FDA: HR-positive, HER2-negative advanced or metastatic breast cancer

Mechanism of Action: Ibrance is an oral CDK4/6 inhibitor, similar to Verzenio. It works by inhibiting CDK4/6, which leads to cell cycle arrest in the G1 phase. This action reduces cancer cell proliferation, particularly in HR-positive breast cancer.

9. Perjeta (Pertuzumab) - $3 billion

Indications Approved by FDA: HER2-positive breast cancer

Mechanism of Action: Perjeta is a monoclonal antibody that targets the HER2 receptor, a protein that is overexpressed in some breast cancers. Perjeta binds to a different epitope on HER2 than Herceptin (trastuzumab), allowing for a more comprehensive blockade of HER2 signaling. This dual inhibition results in a more potent suppression of tumor growth.

10. Tecentriq (Atezolizumab) - $3 billion

Indications Approved by FDA:
  • NSCLC
  • SCLC
  • Urothelial carcinoma
  • Triple-negative breast cancer (TNBC)
  • Hepatocellular carcinoma (HCC)
Mechanism of Action: Tecentriq is a monoclonal antibody that targets PD-L1, similar to Imfinzi. By blocking the PD-L1/PD-1 interaction, Tecentriq reactivates T cells to detect and destroy cancer cells.


Sources:

Summit Therapeutics falls after mixed data from late-stage study of Ivonescimab plus chemotherapy cancer trial: Update (May 2025)


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