Lung cancer KOLs are generally positive on ASCO data progress, with sac-TMT and ivonescimab as the core focal points

Overview

This report is a global pharmaceutical sector meeting note based on Goldman Sachs' post-ASCO interviews with two lung cancer KOLs, focusing on the first-line metastatic non-small cell lung cancer treatment landscape, as well as the clinical read-throughs for MRK/Kelun's sac-TMT, SMMT/Akeso's ivonescimab, AZN's Datroway, and PD1/L1xVEGF programs related to BNTX/BMY and PFE. The overall conclusion is positive, but it repeatedly emphasizes that results from China studies need to be validated in global Phase III trials.

Core views

The core views include: first, sac-TMT showed strong PFS performance in OptiTROP-Lung05, and KOLs believe its toxicity resembles common chemotherapy or ADC toxicities and is generally manageable, with the low discontinuation rate boosting confidence; second, ivonescimab's OS benefit in HARMONi-6 is clinically meaningful, supporting the PD1xVEGF mechanism, but the subgroup aged over 65, the single-region study design, and differences in global populations still warrant attention; third, follow-up data from the global HARMONi-3 study, especially the squamous NSCLC cohort, is a key catalyst for the SMMT investment thesis; fourth, Datroway has advantages in earlier launch and physician experience, but if sac-TMT's global trial reproduces the efficacy and safety seen in China, it could become a stronger competitor.

Analysis framework

The report mainly uses KOL expert interviews and clinical data read-through analysis, comparing ASCO-disclosed China and global NSCLC data with current first-line treatment standards, while evaluating the investment implications in combination with Goldman Sachs' 12-month target prices for MRK, SMMT, and AstraZeneca, DCF/P/E valuation, risk-adjusted DCF, and M&A scenario valuation frameworks.

Methodology notes

• Expert InterviewsKOL Interviews

  Feedback from lung cancer clinical experts

  Goldman Sachs interviewed two lung cancer KOLs, one from Johns Hopkins University School of Medicine and Trinity College Dublin, and another from Stanford University, to assess the impact of ASCO data on NSCLC treatment practice.

• Clinical Trial AnalysisASCO Data Read-Through

  Extrapolation from China studies to global trials

  The report compares studies such as HARMONi-6, OptiTROP-Lung05, and HARMONi-3, focusing on how PFS, OS, HR, safety, patient age structure, and geographic differences affect global commercialization judgments.

• Valuation FrameworkRisk-adjusted DCF and P/E Valuation

  Target price formation for pharmaceutical companies

  SMMT's target price is based on a blend of 85%/15% risk-adjusted DCF value of $35 and theoretical M&A value of $73; AstraZeneca's target price is based on a 50/50 blend of DCF and P/E; MRK's target price uses a multiple of adjusted EPS.

• Equity FactorsGS Factor Profile

  Growth, financial returns, valuation multiples, and composite factors

  Goldman Sachs' factor framework compares individual stocks with the market and industry peers across growth, financial returns, valuation multiples, and composite percentiles, though this section is mainly for disclosure and methodology explanation.

Asset mapping & comparison

Structured mapping from thesis to named assets (strengths, weaknesses, peers, risks).

• MRK / Merck & Co.

  Keytruda is an important benchmark in current NSCLC treatment and multiple control arms; MRK is also related to the Kelun-linked sac-TMT program.

  Strengths

  Keytruda's treatment position is well established, and if sac-TMT data are successfully validated globally, it could strengthen the lung cancer pipeline; Goldman Sachs rates it Buy with a target price of $137.

  Weaknesses

  Patent expiry pressure on Keytruda, limited global relevance of monotherapy controls, and pipeline asset failure risk.

  Comparison

  KOLs believe sac-TMT may have superior efficacy and safety potential versus AZN's Datroway, but it still lags Datroway in development and clinical experience base.

  Risks

  Faster-than-expected erosion from Keytruda LOE, lower-than-expected SubQ Keytruda conversion, regulatory/vaccine/tariff pressures, and M&A uncertainty.

• SMMT / Summit Therapeutics Inc.

  Through partner Akeso's ivonescimab, it has exposure to the PD1xVEGF bispecific antibody and the global Phase III HARMONi-3 catalyst.

  Strengths

  HARMONi-6 showed a meaningful OS benefit, with PFS HR=0.60 and OS HR=0.66; KOLs believe the probability of a positive final PFS result in the squamous cohort of HARMONi-3 is relatively high.

  Weaknesses

  Core evidence still largely comes from China studies, and there is uncertainty around global translation, manufacturing, and the regulatory pathway.

  Comparison

  KOLs believe ivonescimab may be superior to Keytruda, but the magnitude of benefit still needs to be clearly demonstrated in the global Phase III HARMONi-3 study; competition among PD1/L1xVEGF peers is also accelerating.

  Risks

  China data may fail to translate to global studies, unexpected safety issues, clinical delays, regulatory failure, supply chain impact from U.S.-China relations, financing dilution, and stronger competitor data.

• AstraZeneca / Datroway

  Datroway has a development lead and established clinical experience in ADC treatment for NSCLC.

  Strengths

  It has already received FDA approval as monotherapy and accumulated physician usage experience, making it easier to enter treatment pathways in combination with IO therapies; Goldman Sachs rates it Buy.

  Weaknesses

  In the AVANZAR trial, the use of Imfinzi rather than Keytruda in the control arm creates interpretation risk, and it may also face efficacy and safety competition from sac-TMT.

  Comparison

  Compared with sac-TMT, Datroway's advantage lies in development progress and clinical familiarity; in contrast, if sac-TMT's global data are reproduced, it may be more attractive in terms of efficacy and safety.

  Risks

  Clinical failure, commercial execution, pricing pressure, competitive progress, and patent exposure.

• BNTX/BMY pumitamig and PFE PF’4404

  As other bispecific programs within the PD1/L1xVEGF category, they provide cross-program read-through for ivonescimab and similar mechanisms.

  Strengths

  KOLs believe the efficacy decay from China data to global data is limited, broadly supporting the PD1/L1xVEGF category.

  Weaknesses

  The report does not provide full project-level valuation or specific target prices, and the investment conclusion is more about mechanism read-through than changes in single-company ratings.

  Comparison

  Together with ivonescimab, they reinforce the credibility of the PD1/L1xVEGF mechanism, but in the future they will face comparisons in efficacy, safety, and development speed among peer programs.

  Risks

  Homogeneous competition, failure of global validation, safety differences, and slower-than-expected clinical development progress.

• CStone Pharmaceuticals CS2009

  A trispecific PD1xCTLA4xVEGF molecule, identified by KOLs as a new lung cancer treatment direction worth watching.

  Strengths

  It represents a new paradigm of novel-novel combinations and trispecific antibodies, potentially expanding the combination space in lung cancer immunotherapy.

  Weaknesses

  The report mentions it only as an early point of interest and lacks mature clinical and commercialization data.

  Comparison

  Compared with PD1xVEGF and ADC programs already in later-stage validation, trispecifics are still earlier-stage but may offer greater mechanistic differentiation.

  Risks

  Early-stage R&D failure, complex toxicity, insufficient clinical benefit, and uncertainty around the competitive pathway.

Key data

• Report Date2026-06-02The report was published as Equity Research on 2 June 2026.
• HARMONi-6 EfficacyPFS HR=0.60; OS HR=0.66KOLs believe the decline in benefit from PFS to OS is relatively small, supporting ivonescimab's efficacy signal.
• sac-TMT Discontinuation RateApprox. 5%One KOL described this discontinuation rate as outstanding, though adverse events such as stomatitis and ILD still need attention.
• Clinical Decision HR ThresholdOS generally needs to be below 0.8 to be statistically significant; a clinically meaningful HR is around 0.75KOLs also noted that if sac-TMT's next data set shows an HR of 0.7 to 0.8 and a response rate of 65% to 70%, it may have a better chance of changing the standard of care.
• SMMT Target Price$41Based on a blend of 85%/15% risk-adjusted DCF value of $35 and theoretical M&A value of $73.
• MRK Target Price$137Based on 14.0x Q5-Q8 adjusted EPS.
• AstraZeneca Target Price16,525p / $219Derived from a 50/50 blend of DCF and P/E valuation.

Impact & implications

The report is broadly positive on innovative lung cancer drug assets, especially benefiting companies that own or co-develop sac-TMT, ivonescimab, and the PD1/L1xVEGF mechanism. For investors, the near-term key issue is not the standalone China study data itself, but whether these data can be reproduced in global Phase III trials, across different age structures, and in different histological populations; if reproduced, these drugs could reshape the competitive landscape of first-line NSCLC and create commercial pressure on Keytruda, Datroway, and other IO/ADC combinations.

Risks

• Single-region China clinical data may fail to be reproduced in global populations, especially as age structure, smoking-related pathology differences, and histological differences may affect efficacy.
• sac-TMT still requires final global OS data confirmation, and safety issues such as stomatitis, ILD, and individual tolerance differences related to ADCs need continued monitoring.
• Controversy over ivonescimab's benefit in the subgroup aged over 65 may affect physician and regulatory judgment regarding global applicability.
• The competitive landscape among Datroway, sac-TMT, and PD1xVEGF bispecific antibodies may change rapidly with subsequent global Phase III data.
• Factors such as Keytruda patent expiry, payer utilization pressure, the regulatory environment, slower vaccine business, clinical failure, and tariffs may affect valuations of relevant companies.

What to watch

• Final PFS readout from Cohort 2H of the global Phase III squamous NSCLC HARMONi-3 study.
• Final OS, PFS, response rate, and discontinuation rate data from the global sac-TMT study.
• Validation of the controversy around the subgroup aged over 65 in HARMONi-6 within global populations.
• AVANZAR trial results for Datroway and the impact of its control arm selection on clinical interpretation.
• PD1/L1xVEGF peer programs, including BNTX/BMY pumitamig, PFE PF’4404, and other global data.
• Subsequent clinical progress of ADC plus IO, trispecific PD1xCTLA4xVEGF, RAS inhibitors, and their combinations with IO/ADC.