Biotech’s Obsession with Oncology: Innovation Engine or Investor Mirage?
By Jenna Levenson, PhD, RN, MS
Another look inside the clinical trial pipeline no one wants to question.
We need to talk about the imbalance no one in biotech wants to confront - cancer accounts for less than 15% of the global disease burden, yet it attracts over 40% of all biopharma R&D investment. It is the darling of investors, the launchpad for IPOs, and the beating heart of most pharma pipelines.
But what if we are overbuilding the house of oncology—and underdelivering for patients?
The uncomfortable math of modern oncology
At last count, more than 1,200 oncology drugs were in clinical development globally. The vast majority target overlapping pathways (PD-1/PD-L1, HER2, CD19, etc.), compete for the same narrow patient pools, and chase similar endpoints using trial designs engineered more for speed than substance.
Despite this surge of activity, the failure rate remains brutally high, especially in late-stage trials. Some studies peg oncology’s Phase III success rate as low as 3.4%. Even approved therapies often offer only marginal improvements in overall survival—sometimes measured in weeks, not years.
And yet, we pour in more money.
Are we funding breakthroughs—or just better investor optics?
Here’s what’s really driving the frenzy:
Accelerated approval pathways based on surrogate endpoints like tumor shrinkage or PFS.
Investors prioritizing short-term exit strategies over long-term clinical impact.
"Me too" molecules with slight tweaks to win a share of already crowded markets.
AI drug discovery hype that creates the illusion of progress without the data to back it up
What we are seeing is less about curing cancer—and more about feeding the machine of biotech valuation.
Meanwhile, real-world impact lags
Despite billions in investment, many patients still:
Struggle to access therapies due to cost or limited biomarker eligibility.
Experience minimal benefit from “personalized” treatments in the real world.
Drop out of trials due to complex protocols, travel demands, and lack of patient-centric design.
In short: our oncology pipeline is bloated. Our clinical development model is showing signs of strain. And our focus may be more aligned with Wall Street than with the patients we claim to serve.
3 uncomfortable questions every biotech leader should ask:
Are we investing in meaningful innovation—or just playing the valuation game?
What would happen if we shifted even 10% of oncology R&D funding toward mental health, chronic disease, or infectious threats?
Is the FDA's flexibility around accelerated approval enabling speed—or eroding standards?
We can’t keep equating activity with impact. The future of biotech should be built on outcomes, not optics.
So, before you fund the next PD-1 combo or throw your support behind another overhyped T-cell engager, ask yourself:
Are we solving cancer—or just trading on it?
What do you think: is oncology still the best place to drive innovation—or are we inflating a therapeutic bubble that’s due for a correction? Let’s Talk.