April 29, 2026

Oncology Intelligence Digest • April 28, 2026

Oncology Intelligence Digest
April 28, 2026
AbbVie committed up to $1.45 billion to enter the pan-RAS inhibitor space through its Kestrel option deal for KST-6051. Eli Lilly expanded its hematology presence with a $2.3 billion acquisition of Ajax Therapeutics and its Type II JAK2 inhibitor AJ1-11095 for myelofibrosis. Compass Therapeutics' stock dropped 63% after its bispecific tovecimig met PFS but missed OS in the Phase 2/3 COMPANION-002 biliary tract cancer trial, confounded by 54% crossover. Jazz Pharmaceuticals received FDA Priority Review for Ziihera (zanidatamab) combinations in first-line HER2+ GEA, with a PDUFA date of August 25, 2026.

Top Stories

AbbVie Places $1.45B Bet on Pan-RAS with Kestrel Option Deal

AbbVie announced on April 28, 2026, a warrant agreement with an exclusive option to acquire Kestrel Therapeutics for up to $1.45 billion (upfront payment, exercise payments, and development/regulatory milestones), marking its entry into the KRAS inhibitor field, according to Endpoints News. Kestrel's lead asset KST-6051, a pan-KRAS inhibitor targeting multiple KRAS mutations, dosed its first patient in a Phase 1 trial in patients with KRAS-driven advanced or metastatic solid tumors, announced the same day. AbbVie will support funding of the KST-6051 program. Revolution Medicines leads the KRAS space with daraxonrasib (RMC-6236) in Phase 3 (RASolute 302 trial: 13.2 vs 6.7 months median OS in pancreatic cancer, HR 0.40), while BMS (via Mirati acquisition, $4.8B cash plus $1B CVR, January 2024) advances adagrasib (Krazati). AbbVie gains optionality in KRAS-targeted oncology Existing KRAS players face intensified competition from well-funded new entrant

Deal Value
$1.45B
RAS-Driven Cancers
30%
Structure
Option Deal

Lilly Pays $2.3B for Ajax Blood Cancer Assets in JAK2 Push

Eli Lilly announced on April 27, 2026, a definitive agreement to acquire Ajax Therapeutics for up to $2.3 billion in cash (upfront and milestone payments), gaining AJ1-11095, a first-in-class once-daily oral Type II JAK2 inhibitor in Phase 1 for myelofibrosis patients previously treated with Type I JAK2 inhibitors, according to Pharmaceutical Technology. Lilly was a founding strategic investor in Ajax since 2019 and participated in its $95 million Series C in 2024. All approved JAK2 inhibitors for myeloproliferative neoplasms bind the Type I conformation; AJ1-11095's Type II mechanism is designed to deliver deeper, more durable efficacy and provide a treatment option for patients who become resistant to existing therapies. Dose selection for future development is expected in 2026. The JAK2 inhibitor market for myelofibrosis is currently dominated by Incyte's Jakafi (ruxolitinib). Lilly establishes meaningful hematology-oncology presence Incyte faces new deep-pocketed JAK2 competitor with differentiated mechanism

Deal Value
$2.3B
Dosing
Once Daily
Development Stage
Phase 1

Compass Therapeutics Stock Drops 63% as Tovecimig OS Data Confounded by Crossover

Compass Therapeutics shares fell 63% on April 28, 2026, after announcing mixed results from the Phase 2/3 COMPANION-002 trial of tovecimig, a DLL4/VEGF-A bispecific antibody, in 168 patients with previously treated unresectable advanced, metastatic, or recurrent biliary tract cancer, according to BioSpace. The trial met its primary endpoint of progression-free survival (4.7 vs 2.6 months, 56% risk reduction) with tovecimig plus paclitaxel versus paclitaxel alone. However, the secondary endpoint of overall survival was not met (pooled OS 8.9 months, not statistically significant), confounded by 54% of control patients crossing over to receive tovecimig. Crossover patients showed OS of 12.8 months versus 6.1 months for non-crossover patients. Compass plans to pursue full approval (not accelerated) and expects a pre-BLA meeting with the FDA mid-year. Compass faces approvability questions despite PFS win PFS benefit and crossover survival data may support regulatory path

Stock Drop
63%
PFS Benefit
4.7 vs 2.6 mo
Crossover Rate
54%

Pipeline Watch

FDA Grants Fast Track to Scancell's iSCIB1+ ImmunoBody® for Advanced Melanoma

According to Targeted Oncology, the FDA awarded Fast Track designation to Scancell Holdings' iSCIB1+, an ImmunoBody® DNA immunotherapy (not a personalized vaccine), for advanced melanoma. In the Phase 2 SCOPE trial, iSCIB1+ in combination with ipilimumab and nivolumab demonstrated 77% PFS at 20 months, compared with 43% for ipilimumab plus nivolumab alone in the historical CheckMate 067 study. Dosing is delivered via needle-free injector. The FDA cleared the IND for a global Phase 3 trial in January 2026, with initiation anticipated in H2 2026.

Source: Targeted Oncology
Astellas Forecasts 5.3% Xtandi Revenue Decline in Fiscal 2026

Fierce Pharma reported that Astellas projects its prostate cancer blockbuster Xtandi (enzalutamide) will see revenues drop 5.3% in fiscal 2026 after growing 5.3% to $6 billion in fiscal 2025. The decline is driven by patent expiry in Europe in 2026 and the U.S. in 2027, with GlobalData projecting sales falling to $2.24 billion by 2030. Astellas is counting on new pipeline assets to offset the anticipated erosion.

Source: Fierce Pharma
Alliance Phase 3 Inotuzumab Ozogamicin Trial in Young Adult ALL Currently Suspended

ClinicalTrials.gov shows that NCT03150693, a Phase 3 trial by the Alliance for Clinical Trials in Oncology combining inotuzumab ozogamicin with frontline chemotherapy (CALGB 10403 pediatric-inspired regimen) in 310 young adults with newly diagnosed B-cell acute lymphoblastic leukemia, is currently suspended — not actively recruiting. The primary endpoint is event-free survival. The study has an anticipated end date of 2027.

Source: ClinicalTrials.gov
Jazz's Ziihera Receives FDA Priority Review for First-Line HER2+ GEA Combinations

Jazz Pharmaceuticals announced on April 27, 2026, that the FDA accepted and granted Priority Review via the Real-Time Oncology Review (RTOR) program to a supplemental BLA for Ziihera (zanidatamab-hrii) in combination with fluoropyrimidine/platinum chemotherapy, with or without tislelizumab (Tevimbra), for first-line treatment of adults with HER2-positive locally advanced or metastatic gastroesophageal adenocarcinoma (GEA). The PDUFA target action date is August 25, 2026. The sBLA is supported by the Phase 3 HERIZON-GEA-01 trial (914 patients, 300+ sites, 30+ countries), which showed median PFS of 12.4 months vs 8.1 months for trastuzumab plus chemotherapy, and median OS of 26.4 months vs 19.2 months in the zanidatamab triplet arm. Zanidatamab has received two Breakthrough Therapy Designations. Ziihera currently holds accelerated approval for previously treated HER2-positive (IHC 3+) biliary tract cancer.

Source: Jazz Pharmaceuticals IR

Competitive Landscape

Pan-RAS Race Expands with AbbVie Joining Crowded Field

AbbVie's $1.45 billion Kestrel option deal intensifies competition in pan-RAS inhibitors, per Endpoints News. Revolution Medicines maintains first-mover advantage with daraxonrasib (RMC-6236) in Phase 3 while BMS leverages its Mirati acquisition ($4.8B cash plus $1B CVR, January 2024) to advance adagrasib (Krazati). Multiple well-funded players now chase the same transformative cancer target.

CompanyAssetDevelopment StageInvestment
Revolution MedicinesDaraxonrasib (RMC-6236)Phase 3Public
Bristol Myers SquibbAdagrasib (Krazati)Approved (G12C)$4.8B + $1B CVR
AbbVieKST-6051 (Kestrel)Phase 1$1.45B
Source: Endpoints News
JAK2 Market Faces New Competition from Lilly Ajax Deal

Lilly's $2.3 billion Ajax acquisition challenges Incyte in blood cancer JAK inhibitors, according to Pharmaceutical Technology. Incyte's Jakafi dominance threatened by new Type II mechanism while Lilly gains meaningful hematology presence through differentiated once-daily AJ1-11095 approach targeting improved tolerability in myelofibrosis.

Source: Pharmaceutical Technology
Bispecific Antibody Sector Consolidation Expected After Recent Failures

Compass Therapeutics' 63% stock drop following tovecimig's OS miss in COMPANION-002 (biliary tract cancer) highlights bispecific approvability challenges, per Fierce Biotech. PFS was met (4.7 vs 2.6 months), but 54% control crossover confounded OS. Compass plans pre-BLA FDA meeting mid-year, pursuing full approval while investors question whether PFS alone supports regulatory path.

Source: Fierce Biotech

Forward Looking

  • Watch for Revolution Medicines' daraxonrasib (RMC-6236) Phase 3 RASolute 302 updates in pancreatic and colorectal cancer through 2026
  • Monitor Lilly's AJ1-11095 Phase 1 dose selection expected in 2026 for differentiated Type II JAK2 inhibitor profile in myelofibrosis
  • Jazz Pharmaceuticals' Ziihera (zanidatamab) PDUFA target date August 25, 2026 for first-line HER2+ GEA combinations
  • Scancell's iSCIB1+ Phase 3 melanoma trial initiation anticipated H2 2026; Compass Therapeutics pre-BLA FDA meeting expected mid-year for tovecimig in biliary tract cancer