Enabling Progress: How To Create The Next Generation of Life Saving Cancer Drugs
- One of the most important figures shaping the development of oncology drugs today, Jacob Van Naarden, Executive Vice President and President of Lilly Oncology has laid out a framework which he believes can power a wave of progress for patients.
- At the San Antonio Breast Cancer Symposium—one of the world’s leading scientific meetings dedicated to breast cancer research, Van Naarden said that Lilly has begun major new efforts to partner with academic institutions, finance larger clinical trials earlier in the progression of cancer, and fundamentally deploy a huge amount of capital to enable progress.
- What does this mean for patients? Cancer drugs reach the market through sustained investment in research and clinical trials. Expanding that investment has the potential to accelerate the development of new therapies, especially as federal funding for cancer research remains uncertain.
For Jacob Van Naarden, Executive Vice President and President of Lilly Oncology, the mission is clear: bring better cancer medicines to more patients—and make them accessible to patients earlier in the disease course, before cancer has the chance to spread and when treatment has the greatest potential to improve outcomes and increase cure rates.
Read MoreAccording to Van Naarden, Lilly’s vision comes together in three major ways: developing more great medicines across a broader range of cancers, moving innovation earlier in the disease course, and expanding the very types of medicines that can be made.
A New Model For Cancer Care Innovation
Lilly is deliberately challenging the long-standing model of cancer drug development—designing large, ambitious trials that move promising medicines earlier in the disease course, when they may have the greatest chance to prevent metastasis and increase the number of patients who are cured.
Historically, new cancer drugs have almost always been tested first in patients with advanced or metastatic disease—not because they are expected to work best there, but because it has been the safest and most ethical place to start. Patients with later-stage cancer have often fewer effective treatment options.
“When you think you have a great medicine, yes, you want to make it quickly available to patients who are in desperate need once their disease has progressed once or more,” says Van Naarden. “But, really, our recurrent observation is that great medicines have their biggest impact when given early in the course of therapy or early in the course of disease.”
The goal is simple but ambitious: help patients sooner, when treatments may have the greatest potential to improve outcomes—or even cure disease.
“Within months, we’re starting earlier stage studies, and I think a historical version of Lilly would sort of wait for the first randomized trial to read out, so you know that you have something before you then commit a lot more investment behind it,” says Van Naarden referring to trials that compare new drugs to the current standard of care and often involve patients with advanced disease who have exhausted other options. “That’s sort of the old model. The new model is like do it all at once. That’s sort of the risk kind of tolerance we can take.”
Major Breast Cancer Clinical Trials
That approach is already taking shape in trials like EMBER-4, which enrolled approximately 8,000 patients with high-risk, hormone-driven (ER+, HER2–) early breast cancer. Rather than waiting for years of metastatic-stage data, Lilly moved imlunestrant—a next-generation oral hormone therapy—into treatment given after initial therapy to help prevent the cancer from coming back, aiming to intervene earlier, before cancer has the chance to return or spread.
“It’s actually the largest cancer clinical trial that Lilly has ever run,” Van Naarden says. “I’m pretty confident that study will be successful. I think that will be a major step change actually for so many tens of thousands of patients who get this diagnosis and are in need of better therapies to really hopefully increase the cure fraction, which of course is why we’re all doing this.”
EMBER-4 reflects a broader shift toward testing innovative therapies earlier in the disease course—a philosophy already bearing fruit in other landmark breast cancer trials, including the recently reported Phase 3 monarchE trial. This trial showed that one of Lilly’s Verzenio (abemaciclib) extended survival for women with the most common type of breast cancer, HR+/HER2-.
“The hope all along was not just that Verzenio could improve outcomes while you’re taking it, but that it actually augments the course of the disease such that when you go off of it, you actually see further benefit accrue to the patient. And that’s what we observed,” Van Naarden says, summarizing the new data. “I think the most recent data we presented is most interesting because for the first time we actually showed that Verzenio improves overall survival for these patients. So patients live longer, taking Verzenio for two years in the adjuvant setting on top of endocrine therapy.”
WATCH: Jacob Van Naarden on How Lilly’s Breast Cancer Strategy Reflects a Portfolio-Wide Shift
Expanding The Oncology Toolkit
Beyond speed, Lilly is also investing in entirely new treatment modalities that could fundamentally change how cancer is treated. “[Another] thing that I think we have the ability to do and we are doing is really increase the types of medicines that we make, which can sometimes require some pretty patient technology building,” Van Naarden says.
One example is radioligand therapy, an emerging approach that delivers targeted radiation directly to tumor cells while sparing healthy tissue and has already shown promise in treating prostate cancer.
“This is not like taking a pill. This is a much more complicated idea, both scientifically, but also in its administration,” Van Naarden explains. “I think it could have major, major impact… I’m hopeful that the field will look at those results over time and say, okay, we have to figure out how to actually do this because the impact is that big.”
A Framework for Investing in Innovation
Backed by its unprecedented financial strength, Lilly now has the flexibility to move faster, invest earlier, and expand the range of cancer medicines it can pursue—reshaping what’s possible in oncology. With this new ‘war chest,’ Van Naarden is not only developing new drugs internally but also by bringing smaller drug developers into the Lilly portfolio on a near constant basis and supporting entrepreneurs and small companies in a whole host of ways.
When it comes to deploying capital, Van Naarden describes his philosophy as “pretty simple” and outlines his investment strategy across three categories.
First, he asks whether a company is built around an underlying technology that could meaningfully impact patient care. “Is there some underlying technology that we want as part of our overall toolkit because we think it can impact care?” he says.
Second—and, he notes, the bulk of the decision-making—comes down to whether that technology can be translated into a medicine with benefits that can be clearly demonstrated in a clinical trial.
Finally, Van Naarden emphasizes that drug development is ultimately a people-driven enterprise. “This business is a people business,” he says, adding that when it comes to acquiring companies, “we want the people—and we pay a lot of attention to that.”
Van Naarden says Lilly partners across the biopharma ecosystem in a wide range of ways—from investing in venture capital firms and directly backing early-stage companies to supporting entrepreneurs emerging from academia as they build new ventures. The company is even investing in physical infrastructure, developing lab space in biotech hubs around the world that can be leased to small companies in need of flexible, early-stage facilities—an often-overlooked gap in the market. These partnerships allow Lilly to build close, collaborative relationships, offer guidance, and share expertise. Ultimately, Van Naarden says the goal is to leverage Lilly’s resources and more than 150 years of experience to help power the next generation of biopharma innovation globally.
“It’s an ambitious thing to say,” he acknowledges, “but you don’t get very far unless you have ambitious goals.”
Together, the approach underscores how Lilly is rethinking its role in oncology at a moment of unusual financial and scientific leverage. By investing earlier in development, widening the scope of technologies it pursues, and embedding itself more deeply across the biopharma ecosystem, the company is positioning itself to influence not just which cancer medicines reach patients, but when and how they do. Whether that strategy ultimately delivers on its promise will be determined over time—by trial results, regulatory decisions, and, most importantly, patient outcomes.
Learn more about SurvivorNet's rigorous medical review process.
