Marketing aside, here are the “Mechanism-of-Action-busters”, i.e. Oncology drugs ranked by their ability to punch the tumor on multiple levels. A: blood vasculature; B: stromal cells, which can be as malignant as the tumor itself (C); D: the immune system is educated by the CAFs into anergy or exhaustion (sleeping mode).

Merck’s Keytruda tops the list – no wonder it sells $30b/year. In contrast, Xtandi (about $2b/yr) only hits the tumor epithelium.

We’ll let you speculate where our PTEN stands 😊