Gui Lan Yao, Leming Shi, Yuanting Zheng
The global oncology drug pipeline is characterized by a tension between the diversification of novel targets and a persistent concentration on a few validated ones. Our analysis of 5127 drugs against 1603 targets categorizes entities as 'proven' (10.4%), 'in development' (53.6%), or 'not progressing well' (36.1%). While single-target agents dominate, dual-target strategies, driven by bispecific antibodies, are the fastest-growing approach. The top 20 proven targets attract over 50 drugs each. Small molecules remain prevalent, but novel modalities are expanding. Clinical validation of a novel target requires a median of 8.0 years with a 22.3% success rate. The USA and China drive 62.7% of global development, with the USA leading in first-in-class (FIC) innovation and China's role increasing since 2020.