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


Keytruda is the world's bestselling cancer drug by a large margin. (Merck & Co.)
Company: Merck & Co.
2024 sales: $29.5 billion

Indications Approved by FDA:
  1. Melanoma, (KEYNOTE-006 and KEYNOTE-054 trials)
  2. Non-small cell lung cancer, (KEYNOTE-010, KEYNOTE-407, KEYNOTE-189, KEYNOTE 671 trials)
  3. head and neck cancer, (KEYNOTE-012 and KEYNOTE-048)
  4. kidney cancer (renal cell carcinoma), (KEYNOTE-426)
  5. classical Hodgkin lymphoma, (KEYNOTE-204)
  6. primary mediastinal large B-cell lymphoma, 
  7. bladder cancer, (EV-302/KEYNOTE-A39) 
  8. microsatellite instability-high (MSI-H) or mismatch repair deficient cancers,
  9. gastric cancer, 
  10. esophageal cancer, 
  11. cervical cancer, 
  12. liver cancer, 
  13. biliary tract cancer, 
  14. Merkel cell carcinoma, 
  15. endometrial cancer, 
  16. tumor mutational burden-high cancer, 
  17. cutaneous (skin) squamous cell carcinoma, 
  18. Triple-negative breast cancer (TNBC). (ASCENT-04/KEYNOTE-D19 Study)
In 2024, Merck's Keytruda (pembrolizumab) achieved global sales of approximately $29.5 billion, representing an 18% increase compared to 2023. Excluding foreign exchange impacts, the growth was about 22%. Keytruda remained the world’s best-selling drug, with multiple FDA approvals in 2024 expanding its indications, including treatments for cervical and endometrial cancers (1, 2, 3, 4, 6).

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. But its reign may be short-lived. 

In 2023, Keytruda’s sales grew 21% at constant exchange rates, reaching $25 billion. At the same time, as GLP-1 diabetes and obesity drugs take the world by storm, Novo Nordisk’s semaglutide franchise—Rybelsus, Ozempic and Wegovy—together generated 145.8 billion Danish kroner ($21.1 billion). That marked a nearly 90% surge over 2022. 

The three semaglutide brands continued their seemingly unstoppable growth into 2024. Their first-quarter sales collectively jumped 48% year over year to 42.2 billion Danish kroner ($6.1 billion), inching even closer to Keytruda’s $6.9 billion haul, which represented a 20% increase over the same period last year. 

Keytruda is no doubt the world's bestselling cancer drug. The next oncology asset on our list, Bristol Myers Squibb and Ono Pharma’s rival PD-1 inhibitor Opdivo, generated $10 billion last year. Johnson & Johnson recorded $9.7 billion for its anti-CD38 multiple myeloma drug Darzalex. 

Keytruda scored two high-profile FDA approvals last year, although one of them wasn’t specifically about the PD-1 drug itself. 

In October 2023, the FDA greenlighted Keytruda as part of a continued neoadjuvant-adjuvant therapy used around surgery in resectable non-small cell lung cancer, making it the first PD-1/L1 inhibitor regimen that’s used both before and after surgery. 

The approval was accompanied by phase 3 data from the KEYNOTE-671 trial showing that, compared with presurgical chemo alone, the addition of Keytruda around surgery significantly cut the risk of death by 28%. Despite perioperative Keytruda’s overall survival win, it remains unclear whether a checkpoint inhibitor is necessary both before and after surgery for all approved non-small cell lung cancer cases. The FDA has indicated it wants to tease out the exact contribution of each phase of treatment to the entire regimen. The ultimate length of treatment will affect Keytruda’s long-term sales potential.

In another major feat, a combination of Keytruda and Astellas and Pfizer’s Padcev won full FDA approval as a first-line treatment for advanced bladder cancer—regardless of the patient’s eligibility for chemotherapy. The approval came after the phase 3 EV-302 trial linked the Keytruda-Padcev combo to a 53% reduction in the risk of death compared with chemo. 

But the EV-302 readout was viewed as more of a success for Padcev and the antibody-drug conjugate modality, especially given Keytruda’s previous stumbles (Lancet Oncology 2021) in first-line bladder cancer as a monotherapy and as part of a combination with traditional chemotherapy. Nevertheless, the EV-302 regimen speaks to Keytruda’s appeal as the combination partner of choice for newer drugs. Another candidate taking that approach is Moderna and Merck’s individualized cancer vaccine, mRNA-4157 (V940). The shot’s cocktail with Keytruda has drawn much interest because of its promising midphase data in resected melanoma.  

However, not all attempts to pair Keytruda up have been successful. Some of the notable failures include Keytruda’s combos with AstraZeneca-partnered Lynparza and Eisai-shared Lenvima.

As Keytruda is slated to fall off the patent cliff in 2028, Merck has been working on a subcutaneous version to potentially soften the blow. However, Merck is behind its rivals BMS and Roche in terms of developing more convenient injections of their PD-1/L1 offerings. A dispute over a microscopic enzyme is threatening Merck & Co. plans to sell a new version of Keytruda, the cancer drug that generates nearly half of the company’s sales. Merck has been tweaking Keytruda to make it easier to use—and to protect billions of dollars in revenue the company could lose after U.S. patent protection runs out in 2028 and rivals can begin selling copycats. The enzyme in the new Keytruda allows it to be injected, rather than given intravenously. It is the subject of a brewing patent dispute between Merck and a biotech called Halozyme Therapeutics. (Wall Street Journal) 

While biosimilars for pembrolizumab are on the horizon, as of mid-2025 no biosimilar versions are yet widely available or approved for commercial use in key global markets. These drugs are biologics (monoclonal antibodies), which are complex to manufacture and subject to patent protections. Pembrolizumab’s patent (held by Merck) is expected to expire in the US around 2028, potentially allowing biosimilars (not generics, due to biologics’ complexity) to enter the market thereafter. Biosimilars are highly similar versions of biologics, requiring clinical trials to demonstrate equivalence, unlike small-molecule generics.

Some countries (e.g., India, China) may produce biosimilar or off-patent versions of ICIs, but these are not FDA- or EMA-approved and lack global standardization. For example, biosimilars for other biologics (e.g., rituximab) exist in India, but no specific pembrolizumab biosimilar is available in major markets.

The Biologics Price Competition and Innovation Act (BPCIA) grants a 12-year exclusivity period for original biologics in the US. Since Keytruda was first approved by the FDA on September 4, 2014, this exclusivity* is scheduled to expire on September 4, 2026 (Eureka). While this could theoretically allow for biosimilar applications, the stronger patent protections, which expire in 2028, are the main barrier to market entry.

*Note: Patent Protection vs Regulatory Exclusivity: Patent protection protects the inventor's intellectual property, including the drug molecule itself and its manufacturing process. Regulatory exclusivity prevents competitor products from entering the market, regardless of patent status. This is distinct from patents and applies to biologic drugs like Keytruda.

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:


Disclaimer

The information presented in this article, is intended for general informational purposes only and should not be construed as professional financial, investment, or medical advice. The revenue figures, company rankings, and projections are based on publicly available data, company reports, and industry estimates as of 2025. All currency conversions, where applicable, are based on annual average exchange rates, and revenues outside the health sciences sector have been excluded for consistency (1).

While efforts have been made to ensure the accuracy and timeliness of the information, Cancer Advisor and the article’s authors do not guarantee the completeness, reliability, or suitability of the content for any particular purpose. Readers are encouraged to verify details independently and consult qualified professionals before making any business, investment, or healthcare decisions based on the information provided.

The article may reference ongoing developments, regulatory actions, or market events that are subject to change. The Cancer Advisor is not responsible for any losses or damages arising from the use of this information.


Related:

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


Comments

Post a Comment

Popular posts from this blog

Ivermectin for Cancer Treatment: Protocols and Evidence (2025 Edition)

By Editorial Team
Image
Ivermectin, a drug primarily used to treat parasitic infections, has gained attention for its potential anti-cancer properties, particularly in alternative treatment protocols. Popularized by figures like Dr. William Makis, these protocols combine ivermectin with supplements and lifestyle changes to target aggressive cancers. This article explores the science, protocols, case reports, risks, and controversies surrounding ivermectin’s use in cancer treatment, providing a balanced guide for readers. What is the Ivermectin Cancer Protocol? Ivermectin cancer protocols, notably those developed by Dr. William Makis, combine ivermectin with supplements like curcumin, vitamin D, and berberine, alongside dietary and lifestyle changes. These protocols are tailored to cancer severity, with higher doses recommended for aggressive cases. The term “turbo cancers,” used by some proponents, refers to rapidly progressing cancers, though it is not a standard medical term and lacks clear scientific defin...
Read more

Fenbendazole vs Ivermectin for Cancer: Differences and Which Is Better?

By Editorial Team
Image
Cancer patients are increasingly inquiring about the use of the anthelmintic drugs Fenbendazole (FenBen) and Ivermectin (IVM) as potential treatments for cancer. Notably, these patients typically fall into two distinct groups, neither of which represents the usual stage 1 or 2 cancer cases where conventional therapies often show promise. The first group consists of older men whose lung or prostate cancer has recurred. Having undergone conventional treatments previously without success, they express skepticism about its effectiveness this time around. The second, larger group comprises younger patients under 40 dealing with aggressive breast cancer, colorectal cancer, or lymphoma—forms of early-onset cancers that appear to lack the typical mutations observed in traditional cases. This article aims to delve into the differences between Fenbendazole and Ivermectin by examining their me...
Read more

Exploring Ivermectin, Mebendazole and Fenbendazole as Aggressive Cancer Treatments: Research, Protocols, and Controversies (2025)

By Editorial Team
Image
Fenbendazole and ivermectin, both antiparasitic drugs that have shown potential in cancer treatment through several mechanisms, such as slowing cancer cell growth and boosting the immune response. Fenbendazole is being studied for its ability to disrupt energy production in cancer cells, effectively hindering their growth. Ivermectin, on the other hand, has been explored in combination with checkpoint inhibitors to boost the immune system's response to tumors—especially in challenging cases like triple-negative breast cancer. Introduction Cancer remains a leading cause of morbidity and mortality worldwide, with an increasing incidence of aggressive and treatment-resistant tumors such as triple-negative breast cancer (TNBC), pancreatic adenocarcinoma, and glioblastoma. Despite significant advances in targeted therapies and immunotherapies, many patients continue to face limited effective options, highlighting an urgent need for novel, affordable, and accessible treatment strategies....
Read more

Top 10 Cancer Fighting Supplements: Evidence Based Literature Review (2025)

By Editorial Team
Image
Are you overwhelmed by conflicting advice on cancer, diet, and supplements ? You’re not alone. With so many claims out there, it’s hard to separate fact from fiction . Can certain foods lower your cancer risk ? Are some foods increasing it without you realizing? What about vitamin and mineral supplements —do they help prevent cancer, or could they actually increase your risk ? The term " anti-cancer supplements " can be misleading. While some nutrients support the body in cancer prevention or treatment, others may interfere with therapies or even pose risks. This guide compiles over 500 scientific references on cancer, diet, and supplements—helping you navigate the facts with ...
Read more

Fenbendazole and Ivermectin for Cancer Case Series: Over 180 Case Reports (2025)

By Editorial Team
Image
Anecdotal reports and preliminary studies suggest that ivermectin and fenbendazole, both antiparasitic drugs, may have potential anticancer effects when used alongside other treatments.  Many people immediately dismiss the potential of ivermectin and fenbendazole when they learn it is “horse or dog medicine”. That initial reaction is overcome when genuine human success stories are told including the lack of serious side effects. The testimonials you are about to read are from individuals who have bravely shared their experiences in the hope of inspiring and uplifting others. These are raw human accounts, unfiltered by gatekeepers—not peer-reviewed studies—but they offer insights that may be valuable to those searching for options. However, we acknowledge that robust clinical trials are needed to provide more conclusive scientific evidence. Contents: Editor's Preface Introduction Fenbendazole and Ivermectin Case Series Compilation (alphabetical) Breast Cancer Success Stories  (...
Read more

Fenbendazole and the Joe Tippens Cancer Protocol: A Comprehensive Guide (2025)

By Editorial Team
Image
The Joe Tippens Cancer Protocol has gained attention as an alternative approach to cancer treatment, popularized by Joe Tippens, a cancer survivor who credits his recovery to fenbendazole, a veterinary anthelmintic, combined with supplements. This article provides a step-by-step guide to the protocol, explores its scientific basis, shares case reports, and discusses risks and controversies to help readers make informed decisions. What is the Joe Tippens Protocol? The Joe Tippens Protocol involves fenbendazole, a drug typically used to treat parasitic infections in animals, alongside supplements and lifestyle changes. The protocol aims to disrupt cancer cell growth, though it remains experimental and lacks approval for human use by regulatory bodies like the FDA. Below is a summary of the protocol’s components, as updated in 2020: Lifestyle Recommendations : Diet : Eliminate refined sugars and processed foods; focus on whole foods like vegetables, lean proteins, and healthy fats. Exerci...
Read more

Fenbendazole Dosage for Cancer in Humans: Benefits, Risks, and Guidelines (2025)

By Editorial Team
Image
What is Fenbendazole? Fenbendazole is an anthelmintic drug commonly used to treat parasitic infections in animals. However, recent research and anecdotal reports suggest it may have potential anticancer properties in humans. How Does Fenbendazole Work for Cancer? Fenbendazole is believed to work by disrupting microtubules in cancer cells, leading to cell cycle arrest and apoptosis (cell death). Some studies suggest it may also modulate glucose metabolism, limiting cancer cell energy supply. Recommended Fenbendazole Dosage for Cancer in Humans The commonly referenced Joe Tippens Protocol suggests the following dosage: Potential Side Effects of Fenbendazole in Humans While generally considered safe, potential side effects may include: Gastrointestinal discomfort (nausea, diarrhea, bloating) Liver enzyme elevation (rare) Bone marrow suppression (rare) Safety and Precautions Medical Supervision: Always consult with a doctor, especially if combining with other treatments. Drug Interaction...
Read more

Fact Check: Can Ivermectin and Fenbendazole Help Treat Cancer?

By Editorial Team
Image
Ivermectin and fenbendazole, originally developed as antiparasitic drugs, are sparking hope in the fight against cancer, fueled by inspiring stories like those shared by actor  Mel Gibson on The Joe Rogan Experience , where he celebrated friends’ remarkable recoveries. While these medications aren’t yet standard cancer treatments, early research is uncovering exciting potential. Scientists are encouraged by promising lab studies and are calling for more clinical trials to confirm their effectiveness and ensure safe use in humans, paving the way for innovative, accessible therapies that could transform lives. Introduction and Context According to a January 22, 2025 fact-check article by AFP: "The anti-parasitic drugs ivermectin and fenbendazole are not currently recommended for cancer, but posts spread across social media touting the medications after actor  Mel Gibson claimed on the Joe Rogan Experience  that they cured his friends' cases of the disease. Oncology ex...
Read more

How One Cancer Survivor Triggered Interest in Repurposed Anti-Parasitic Drugs

By Editorial Team
Image
Joe Tippens never planned to discover a potential remedy that he credits with saving his life and thrust him into the spotlight among notable cancer survivors. The 67-year-old businessman told The Epoch Times he just wanted to beat a type of cancer with an extremely low survival rate. In August 2016, Tippens was diagnosed with small cell lung cancer with a fist-sized tumor. After undergoing chemotherapy and radiation five times a week in Houston, the large tumor in his left lung was eliminated. However, Tippens said the treatments came closer to killing him than curing him. When he returned home to Oklahoma after the New Year, he received devastating news. His oncologist told him he had zero chance of surviving for more than a few months. “In January of 2017, my PET scan lit up like a Christmas tree and I had wide metastasis everywhere, including in my neck, bones, pancreas, and liver,” Tippens said. Finding a Lifeline Facing a prognosis of three months to live, Tippens heard an intrig...
Read more

2025 Study: Ivermectin and Balstilimab for Stage 4 Triple Negative Breast Cancer - Cedars-Sinai Medical Center Study

By Editorial Team
Image
Authors: Yuan Yuan, Jin Sun Bitar, MaLia Walker, David Lin, January Lee, So Yung Choi, Stephen Shiao, Mourad Tighiouart, Paul H. Frankel, Peter P. Lee Affiliation: Cedars-Sinai Medical Center, Los Angeles, CA Abstract e13146  (2025 ASCO Annual Meeting) is a phase 1/2 study of ivermectin in combination with balstilimab after 1-2 prior lines of therapy for triple negative breast cancer Background: Despite recent FDA approval of immune checkpoint inhibitor (ICI) and antibody-drug conjugates (ADCs), therapeutic options for metastatic triple negative breast cancer (mTNBC) remain limited. Preclinical data showed that ivermectin induces robust T cell infiltration into breast tumors and turning “cold” tumors “hot” in mouse model of TNBC. Balstilimab is a fully humanized IgG4 anti-PD-1 agent with proven safety and efficacy in metastatic cervical cancer. The current phase I/II trial is designed to test the safety and efficacy of the combination of ivermectin and balstilimab in patients wit...
Read more