As the biopharma industry navigates the beginnings of 2026, it’s safe to conclude that its development engine is no longer defined predominately by singular breakthroughs. Instead, as the trends illustrate, the more apt description is a convergence—of modalities, technologies, and therapeutic design—that are driving today’s advances in healthcare. Product pipelines, across a range of disease settings, are expanding in breadth and complexity. This, in turn, has raised the need for developers of all sizes, the established and emerging, to differentiate their novel target and treatment pathway pursuits not just on efficacy, but on durability, safety, manufacturability, and ultimately, real-world value and patient outcomes.

This year’s annual Pharmaceutical Executive Pipeline Report, our 21st, spotlights five therapeutic domains where clinical activity is accelerating, late-stage confidence is building, and, perhaps most notably, capital and strategic investment are growing. Together, they signal the evolution poised to steer pharma’s next wave of innovation.

Radiopharmaceuticals and theranostics

Radiopharmaceuticals have entered a decisive growth phase, transitioning into more broad, multitumor oncology pursuits, though earlier-line programs in prostate cancer, for example, remain a major focus. Advances in tumor targeting, isotope chemistry, and imaging have enabled a new generation of radioligand therapies designed for potency and precision.

Drug pipelines are now expanding across solid tumors, with alpha- and beta-emitting isotopes being explored in parallel. Importantly, major pharma companies are investing beyond traditional drug assets and into areas such as isotope supply chains, manufacturing partnerships, and site-of-care readiness.

Combination regimens—pairing radioligands with immunotherapies or DNA damage response agents—are beginning to reshape late-stage development strategies as well.

Helping that cause is a surge in registrational-path drug candidates populating the radiopharma space, rather than solely single flagship product hopefuls. This points to the field’s emergence as a potential foundational territory for precision medicine approaches in cancer. The radiopharmaceuticals market is forecast to grow from $9.1 billion in 2023 to $26.5 billion in 2031, according to a 2025 report by Insight Partners.

Notable projects and developments: 

Novartis: The drugmaker is investigating the expansion of its approved prostate cancer radioligand Pluvicto (lutetium Lu 177 vipivotide tetraxetan) to address earlier stages of the disease. Its Phase III PSMA-DC trial , for instance, is evaluating Pluvicto in patients with prostate-specific membrane antigen (PSMA)-positive metachronous oligometastatic prostate cancer, which represents an intermediate stage between localized and widespread disease. The research aims to determine if this radioligand therapy can offer curative-intent or delayed-progression benefits.

AstraZeneca: AZ is also expanding its radioligand oncology portfolio through various internal programs and partnerships. That includes developing radioligand and DNA damage response combinations and next-generation oncology radioconjugates.Among its hopeful assets is FPI-2265, which is in Phase II for patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC), and AZD2068, currently in Phase I for advanced solid tumors. The latter drug is designed to target cells expressing the EGFR and cMET markers.

Bayer: Is developing alpha-emitter–focused solid tumor programs in the early-to-mid-stage, leveraging the convergence of oncology and nuclear medicine. Focus includes expanding branded drug Xofigo (radium-223) through combination therapies, particularly with novel hormonal agents (eg, enzalutamide, abiraterone), and targeting earlier, asymptomatic mCRPC.

Eli Lilly: Entered the radiopharma space in 2023 behind the $1.4 billion acquisition of Point Biopharma. In 2024, the company struck a deal with Aktis Oncology, worth up to $1.1 billion , and established an alliance with Radionetics Oncology. Assets include PSMA- and somatostatin-targeted candidates in mid- to late-stage trials(PNT2002 for prostate cancer and PNT2003 for neuroendocrine tumors).

RayzeBio (Bristol Myers Squibb [BMS]): Owned by BMS, via the Big Pharma’s $4.1 billion acquisition in 2024, RayzeBio’s lead clinical candidates include RYZ-101, which targets somatostatin receptor type 2, a protein commonly expressed on certain solid tumors, and RYZ-801, an agent in Phase I for hepatocellular carcinoma. The latter is comprised of a proprietary peptide bound to an alpha-emitting radioisotope known as actinium-225.

T-Cell Engagers and Next-Generation Bispecifics

After years dominated by checkpoint inhibitors, bispecific T-cell engager (BiTE) drugs represent the most active experimental zone in immuno-oncology, with hundreds of clinical programs underway. Originally validated in hematologic malignancies, these candidates are now being engineered for solid tumors through improved antigen selection, conditional activation, and safety modulation.

The clinical challenge for T-cell bispecific antibodies has shifted from feasibility (BiTEs are already established as late-line therapies) to optimization—and efforts to balance potency with tolerability, refine dosing regimens, and identify where T-cell redirection best complements existing therapies.

Large pharma organizations have re-entered the space aggressively, either through internal development or targeted acquisitions, while biotech companies continue to drive innovation at the platform level.

Notable projects and developments: 

Amgen:The biotech has continued lifecycle expansion pursuits around Blincyto (blinatumomab), its first-in-class T-cell engager immunotherapy approved to treat CD19-positive B-cell precursor acute lymphoblastic leukemia (ALL) in adults and children. For example, a Phase III trial evaluating the drug as a subcutaneous formulation was recently launched. Blincyto is also being investigated in a Phase I/II trial in relapsed/refractory B-ALL. In November 2025, Imdelltra (tarlatamab),a delta-like ligand 3 BiTE, received full FDA approval for treating extensive-stage small cell lung cancer (SCLC)after prior platinum-based chemotherapy. Amgen is pursuing expansion of Imdelltra in early disease settings for SCLC in combination with other agents and earlier as a monotherapy.

Roche/Genentech: Mosunetuzumab, a CD20xCD3 bispecific sold under the brand name Lunsumio, is in multiple late-stage expansion studies exploring uses in earlier lines of therapy, combined with other compounds, and in different types of B-cell non-Hodgkin lymphomas. In results from registry and Phase II studies released last year, Columvi (glofitamab-gxbm) showed to be superior to non a-CD3xC20 treatments for patients with diffuse large B-cell lymphoma who are refractory or relapse immediately after anti-CD19 CAR T-cell therapy. The drug is approved as an option in this indication after two or more lines of systemic therapy.

Regeneron: The NY-based biotech has a diversebispecific antibody portfolio with multiple oncology targets. The company is testing odronextamab, approved as Ordspono in the EU,ina pair of Phase III trials in first-line diffuse large B-cell lymphoma and second-line follicular lymphoma , respectively.The company, in December, released early-stage data for Lynozyfic in newly diagnosed multiple myeloma, supporting its hope, via Lynozyfic and odronextamab, that bispecifics can achieve desirable responses in early lines of treatment for certain blood cancers and with less onerous options. Regeneron leverages its proprietary VelociSuite technology that create sophisticated, human-like bispecific antibodies that bind two targets. REGN4336, an investigational agent for mCRPC, is currently being evaluated in a Phase I/II study. The drug is designed to connect T-cells to PSMA-expressing cancer cells to trigger tumor destruction.

Genmab: Via Epkinly (epcoritamab), its commercial bispecific co-developed with AbbVie, Genmab, too, is focusing its expansion and pipeline efforts on the drug’s potential as a core therapy across a range of B-cell malignancies. Trials include several ongoing targeting non-Hodgkin lymphoma; diffuse large B-cell lymphoma; follicular lymphoma; Richter’s syndrome, a serious complication of chronic lymphocytic leukemia; marginal zone lymphoma; and central nervous system lymphoma. Genmab is pursuing bispecific products beyond hematologic cancers, tapping its DuoBody platform. That includes targeting solid tumors, such as lung and head/neck, while also exploring non-oncology settings such as Parkinson’s disease. Late-stage candidate petosemtamab holds particular promise for head and neck squamous cell carcinoma. The EGFRxLGR5 bispecific antibody is in two pivotal Phase III trials testing it as a first-line therapy.

Pfizer: An asset licensed from 3SBio in an up-to$6billion deal struck last May, Pfizer is focusing efforts on advancing promising bispecific antibody candidate SSGJ-707 (PF-08634404) into broader global development. The PD-1 plus VEGF targeter is hopeful of treating non-small cell lung cancer, colorectal cancer, and gynecological tumors, potentially displacing current standards of care such as Keytruda and Avastin.Pfizer also boasts approved BCMA x CD3 bispecificElrexfio (elranatamab) for multiple myeloma, where, like others, the company is exploring expansion pursuits in the clinic.

Neurodegeneration advances to systems-level development

Neurodegeneration remains one of biopharma’s most complex frontiers—but one where clinical pipelines are now broader, deeper, and better defined than perhaps at any point in the past decade.

Alzheimer’s disease (AD) anchors the space, with late-stage trials exploring amyloid, tau, neuroinflammation, synaptic health, and metabolic dysfunction. Importantly, companies are shifting efforts toward earlier intervention, patient stratification, and combination logic, supported by advances in blood-based biomarkers and imaging diagnostics.Parkinson’s disease and amyotrophic lateral sclerosis (ALS) pipelines are also expanding, particularly around protein aggregation, mitochondrial biology, and gene-environment interactions.

From a development standpoint, neurodegeneration has become a proving ground for adaptive trial designs, surrogate endpoints, and long-duration outcome modeling. Commercially, the field continues to represent one of the industry’s higher-stakes bets. Hopes, however, remain steady that incremental and promising clinical gains will ultimately translate to transformative patient impact and health outcomes, along with long-term franchise value.

Notable projects and developments: 

Lilly: Remternetug (LY3372993), an anti-amyloid monoclonal antibody, is in Phase III trials for AD. The program is focusing on delivery and scalability, including the feasibility of self-administration via a subcutaneous injection to improve convenience for early-stage AD patients as an alternative to frequent clinic visits for intravenous(IV) administration.Lilly’s LY3954068 is currently in a Phase I study for individuals with early symptomatic AD. The experimental antisense oligonucleotide is designed to reduce tau protein levels to slow disease progression.

Roche/Genentech: After promising Phase II results for amyloid reduction and biomarker changes, the investigational biologic trontinemab (RG6102) is advancing into Phase III for AD. It uses “brain shuttle” technology to boost blood-brain barrier crossing, targeting and rapidly clearing amyloid plaques with potentially fewer side effects than existing drugs (ie, amyloid-related imaging abnormalities). In Parkinson’s disease, Roche/Genentech is developing prasinezumab, which targets a hallmark of the disease in the brain—the build-up of alpha-synuclein proteins that destroy dopamine neurons. A potential disease modifier, the drug, now in Phase III, delivered mixed results in Phase II trials, with subgroup analyses suggesting benefits for faster-progressing patients.

Biogen: Expansion trials for approved ALS drug Qalsody (tofersen) are focusing on presymptomatic superoxide dismutase 1 (SOD1) protein carriers to determine if starting SOD1-ALS antisense therapy before symptoms might delay onset. Long-term safety and real-world use data, along with presymptomatic intervention, remain potential major scientific frontiers in fighting ALS.

AbbVie: In September 2025, the Big Pharma submitted a new drug application to the FDA for tavapadon, a novel selective dopamine D1/D5 receptor partial agonist studied as a once daily oral treatment for Parkinson’s disease. Tavapadon aims to reduce motor fluctuations and “off” time for patients by providing a steady, direct-pathway activation.

Biohaven: After a setback for its glutamate modulator, troriluzole, for the treatment of spinocerebellar ataxia, a rare neurodegenerative disease (the FDA rejectedtroriluzole’s approval last fall), the Pfizer spinout is focusing on such late-stage programs as BHV-1400 for IgA nephropathy, BHV-1300 for Graves’ disease, and the Kv7 ion channel activator opakalim for epilepsy and depression.

uniQure: Despite recent data criteria concerns from the FDA in pursuing accelerated approval, uniQure still hopes to submit a biologics license application via this regulatory pathway for AMT-130, its one-time gene therapy for Huntington’s disease (HD). The first gene therapy to enter clinical trials for HD, AMT-130 is designed to silence the huntingtin gene and reduce mutant protein production. Thirty-six-month Phase I/II data showed that high-dose AMT-130 slowed disease progression by 75% as measured by the composite Unified Huntington’s Disease Rating Scale.

“Obesity-plus” indications: The focus shift in chronic disease

The GLP-1 era, from the class’s meteoric R&D rise to its prominence now as a commercial power and lightning rod in market access and public health circles, has forever altered the landscape for cardiometabolic medicine. GLP-1 glitz aside, however, pipeline attention surrounding the space in 2026 will be influenced more by what comes next and the potential new achievements on the horizon. For example, developers are now pursuing agents that improve durability, tolerability, and metabolic breadth, with an eye toward long-term disease management and modification.

Next-generation candidates include amylin analogs, dual- and triple-agonist peptides, and combination regimens designed to address obesity-linked comorbidities such as cardiovascular disease, osteoarthritis, sleep apnea, fatty liver disease, and even addiction-related disorders.

Hence, late-stage clinical trials are increasingly emphasizing outcomes beyond weight reduction, including cardiovascular risk, functional improvement, and adherence.

For biopharma companies eager to tap this lucrative space, where activity and dealmaking continue to grow considerably, the challenge is no longer simply proving efficacy—it is building sustainable, scalable chronic-disease franchises in an intensely competitive market. Differentiation will hinge on dosing convenience, side-effect profiles, access strategies, real-world persistence, and more.

Notable projects and developments: 

Lilly: Pacing the latest expansion efforts in this category for the Zepbound and Mounjaro (tirzepatide) maker is retatrutide, an experimental triple-agonist drug being studied for weight loss and diabetes. A dedicated cardiovascular and kidney outcomes trial is also underway for retatrutide, signaling the shift from a weight-loss percentage focus to event reduction and payer-grade evidence. Unlike Lilly’s current tirzepatide big sellers, retatrutide activates three key hormone receptors: GIP, GLP-1, and glucagon.

Novo Nordisk: The company is notably guiding semaglutide lifecycle expansion pursuits in cardiovascular risk reduction, osteoarthritis, and liver disease. Additionally, a fixed-dose combination of cagrilintide (an amylin analogue) and semaglutide, known as CagriSema, is in development for chronic weight management and type 2 diabetes. In Phase III trials of the potential Wegovy follow-on, adults with obesity lost an average of ~23% of their body weight, with more than 90% of participants achieving at least 5% weight reduction. Trials are ongoing testing semaglutide’s ability to potentially reduce liver inflammation and fibrosis in patients with non-alcoholic steatohepatitis; and mid-stage studies are exploring whether semaglutide can reduce daily alcohol intake, particularly in patients with alcohol-related liver disease. In November, Novo Nordisk released readouts from its Evoke and Evoke+ trials of semaglutide for individuals with early-stage AD. While the studies did not meet their primary endpoints, the data signaled a fundamental shift in how researchers can approach the development of new AD drugs, by expanding beyond amyloid to target the complete pathobiology of the disease.

Pfizer: PF-08653944, a GLP-1 asset brought over as part of the acquisition of Metsera, showed positive Phase IIb results in data released earlier this month. The ultra-long-acting injectable generated up to 12.3% placebo-adjusted weight loss at 28 weeks, adding credence to the promise of potential monthly dosing in this class.

Amgen: MariTide (maridebart cafraglutide), a monthly-dosed antibody-peptide conjugate, is in mid-stage trials for obesity and type 2 diabetes. Phase II extension results, unveiled in January, emphasized the drug’s utility for weight-loss maintenance even with lower or less-frequent dosing. With its potential for monthly or even quarterly dosing, MariTide, which has a 21-day half-life, could position as a differentiator versus weekly injectables. The drug is also being studied for associated comorbidities in obesity, including heart failure, chronic kidney disease, and obstructive sleep apnea.

Boehringer Ingelheim: Survodutide, a dual glucagon/GLP-1 receptor agonist licensed to Boehringer from Zealand Pharma, is in advanced clinical development for metabolic dysfunction–associated steatohepatitis (MASH) and obesity. The agent has been granted FDA breakthrough therapy and fast track designations for MASH with fibrosis, with Phase III trials underway following positive Phase II results showing significant improvements in liver fibrosis and reduction in liver fat.

Viking Therapeutics: Its novel GLP-1/GIP dual agonist, VK2735, in Phase II trials, demonstrated weight loss up to ~14.7% at 13 weeks with no clear plateau signal. The results keep the drug candidate on the short list of credible challengers to Big Pharma’s pacesetters in the category. A Phase III program is underway for VK2735, which is being developed in subcutaneous and oral forms for the treatment of metabolic disorders, and is showing potential as well in reducing prediabetes and metabolic syndrome.

Immunology and inflammation: Pharma’s durable innovation engine

Immunology and inflammation continue to rank among the industry’s most consistently productive areas of drug development, combining high unmet need with repeatable lifecycle opportunities.

As legacy biologics face biosimilar erosion, pipelines are shifting toward next-generation mechanisms, including selective cytokine modulation, oral small molecule drugs, and tissue-targeted approaches. Development activity spans autoimmune, inflammatory, and allergic diseases, with particular focus on inflammatory bowel disease (IBD), dermatology, rheumatology, and respiratory conditions. Notable targets include IL-17 and IL-23 refinements and TYK2 inhibition.

The emphasis is increasingly on precision immunology, with researchers aiming to preserve efficacy while improving safety and long-term tolerability. Rather than broad immune suppression, they are seeking selective pathway modulation.

With a steady flow of Phase II and III readouts and a wide range of indications supporting lifecycle expansion, immunology continues to serve as a cornerstone of Big Pharma R&D portfolios—and a proving ground for innovation that balances scientific ambition with the commercial realities of maintaining value in crowded, chronic disease markets.

Notable projects and developments: 

Merck/MSD: Tulisokibart, developed by Merck (known as MSD outside of the US), is in Phase III trials for ulcerative colitis (UC) and Crohn’s disease, with the anti-TL1A monoclonal antibody expanding into additional immunomodulatory therapy settings as well. For instance, the company recently launched Phase IIb trials in hidradenitis suppurativa, axial spondyloarthritis, and rheumatoid arthritis (RA). The moves signal confidence in TL1A as a multi-disease node, and reinforces its emergence as one of the most competitive target spaces in the field.

Takeda: Recent Phase III pivotal study data for zasocitinib, the organization’s next-gen oral TYK2 inhibitor, met all primary and ranked secondary endpoints in patients with moderate-to-severe plaque psoriasis. More than half of participants treated with zasocitinib achieved clear or almost clear skin, and, on average, about 30% achieved completely clear skin by week 16. The results boosted the argument that “oral immunology” mechanisms can potentially rival injectable biologics in this therapeutic setting. Takeda is currently evaluating the safety and efficacy of zasocitinib in a head-to-head study against Sotyktu (deucravacitinib) in plaque psoriasis. The drug is undergoing Phase III studies in psoriatic arthritis as well.

Sanofi: The Big Pharma’s potential Dupixent successor, amlitelimab, was headed to regulatory approval submission after largely positive results from a pair of Phase III trials, from which data was released in January. The anti-OX40 ligand monoclonal antibody demonstrated significant efficacy in treating moderate-to-severe atopic dermatitis, with strong, durable responses in US patient cohorts. Results were mixed regarding its EU endpoint, though the data indicated potential for amlitelimab’s infrequent dosing, which, with additionalPhase III readouts to come, could help it stand out vs current standards of care.

J&J: Icotrokinra, developed via a collaboration between J&J’s Janssen Biotech and Protagonist Therapeutics, is a potential first-in-class targeted oral peptide presently is Phase III for treating moderate-to-severe plaque psoriasis and other immune-mediated diseases. In the crowded, biologics-dominated IL-23 therapy space, the once-daily pill offers the promise of an oral alternative with high efficacy and durable, long-acting skin clearance (In late-stage studies, it generated 72% to 85% clear or almost clear skin in hard-to-reach areas). Following positive Phase IIb data, icotrokinra is also moving into Phase III trials for UC.

BMS: Approved for plaque psoriasis, Sotyktu, an oral TYK2 inhibitor that targets IL-23, IL-12, and type 1 interferons, is advancing in clinical development for psoriatic arthritis, lupus, and IBD. The drug offers a potential targeted, non-biologic alternative in addressing those conditions.

AbbVie: The Humira maker is pursuing lifecycle expansion for its two follow-on blockbusters Skyrizi and Rinvoq, eyeing rapid and broad penetration into indications such as IBD, alopecia, vitiligo, and lupus.In next-gen treatment pursuits, AbbVie is developing an in vivo CAR T therapy, CPTX 2309, with Capstan Therapeutics, which it acquired for $2.1 billion last year. The early-stage drugtargets CD8 and T cells for B cell-mediated autoimmune diseases.

Pfizer: Its new autoimmune candidate, PF-08065010, entered Phase I last month for possible future use in RA and lupus. The drug is being evaluated as an injection and IV infusion.

Roivant/Roche: RVT-3101 (afimkibart), developed by Roivant and Roche, which acquired the asset via its 2023 acquisition of Telavant, is nearing Phase III trials for UC and Crohn’s disease. The anti-TL1A-antibody is designed to specifically target inflammation and fibrosis. Phase II results of RVT-3101 revealed 40% to 43% clinical remission rates at week 56 in biomarker-positive patients.

The path forward

Together, these five therapeutic areas explored reflect an industry that is rewiring how innovation is pursued, shifting increasingly from single-asset bets toward more platform-led, portfolio-driven development efforts. As pipelines mature in 2026, success will hinge not only on scientific novelty, but on execution, particularly related to manufacturing readiness, trial design sophistication, and alignment with real-world care pathways.

For pharma leaders, the collective drug pipeline is no longer just a preview of what’s coming—it’s a strategic blueprint for the future.