The balance sheet behind the oncology headlines
Oncology news tends to be written as science. For an investor it is also a question of who can afford to keep funding the science. The most reliable numbers in our records belong to Merck & Co., Inc., whose filings with the U.S. Securities and Exchange Commission we have checked. They show a company with a lot of room to spend. They also show costs that are moving faster than they were a year ago.1
Start with cash. Merck reported $6.841 billion at the end of fiscal 2023, $13.242 billion at the end of 2024 and $14.565 billion at the end of 2025.1 That is more than double in two years. The quarterly figures show it was not a smooth climb. Cash was $11.304 billion at the end of Q2 2024, $8.007 billion in Q2 2025 and $6.849 billion in Q2 2026. The peak in our records is $18.169 billion at the end of Q3 2025.1
Cash at the end of Q1 2026 was $5.327 billion, down from $14.565 billion three months earlier.1 That looks alarming but is partly a pattern. Merck's first quarters are low every year: $5.579 billion in Q1 2024 and $8.629 billion in Q1 2025.1 The Q1 2026 figure is still the lowest of the three. Our verified records do not say why cash moves like this, so we do not guess. They show the swings, not the reasons.
What Merck spends on building things
Capital expenditure is money spent on plants, equipment and facilities. For a drug company launching new biologic products it is a useful sign of how seriously the company is preparing to manufacture them. Merck's capex was $3.863 billion in fiscal 2023, fell to $3.372 billion in 2024 and rose to $4.112 billion in 2025, a jump of roughly 22% in the last year.1
The first quarter of 2026 tells a slightly different story. Capex was $991 million, against $1.328 billion in Q1 2025, a fall of about a quarter.1 One quarter does not make a trend, and Q1 2024 was lower still at $861 million.1 For now the full-year number shows a company investing more, and the latest quarter shows a pause. We will watch whether the second half of 2026 resumes the climb.
The cost side is rising faster
Cost of revenue is what it costs the company to make and deliver what it sells. For the full year it rose from $16.126 billion in 2023 to $15.193 billion in 2024, then to $16.382 billion in 2025, up about 8% in the last year.1
The first half of 2026 is moving faster. Q1 2026 cost of revenue was $4.195 billion against $3.419 billion a year earlier. Q2 2026 was $4.395 billion against $3.557 billion.1 Those are increases of roughly 23% and 24%. Our records do not include Merck's revenue for these periods, so we cannot say whether sales grew as fast. Without that, we cannot tell whether margins are squeezed or the business is simply bigger. Readers should look at revenue before drawing a conclusion.
One note for readers who hold broad index funds: our records do not contain Merck's weighting in any index, so we will not guess whether you already own it.
The two dates that will test the pipeline
Merck's money is going toward a pipeline in which several approaches are converging. The first is the personalized mRNA vaccine Merck developed with Moderna, which in an August 19, 2026 trial result stopped melanoma, a form of skin cancer, from returning.2 Moderna and Merck plan to present detailed results at the ESMO oncology congress on October 24 and to talk with regulators about potential filings.3 Until that data is public, the headline result is an announcement, not a dataset that outsiders can check.
The second is the pairing of antibody-drug conjugates, which deliver a toxic payload to cancer cells, with bispecific antibodies, which grab two targets at once. Summit's marketing application for ivonescimab, based on the HARMONi trial, carries an FDA goal date of November 14, 2026.4 On October 2, Summit also announced a trial collaboration with Daiichi Sankyo and AstraZeneca to test ivonescimab alongside Datroway across multiple solid tumor settings, intending to include breast and lung cancer.5 For investors, the question is how much each partner is paying to find out if the combination works, and our dossier does not contain those terms.
A third signal comes from Europe. The EU's drug committee, the CHMP, recommended Gilead's Trodelvy plus Keytruda for first-line PD-(L)1-positive metastatic triple-negative breast cancer on July 24, 2026.6 Evandro de Azambuja said that, if authorized, the combination "would build on the recent approval of Trodelvy monotherapy" in the first line.6 That is a close paraphrase of the longer quote in our records, which is truncated, so we attribute only the substance. Keytruda is Merck's product, so this is another way Merck's balance sheet is tied to the combination race.
Commercial strength: Novocure shows what a working oncology product earns
The strongest independent commercial datapoint is Novocure. Its second-quarter 2026 revenue was $184 million, up 16% year on year, driven by 18% growth in active patients across indications.7 It also received a CE Mark for Optune Pax in locally advanced pancreatic cancer, with Germany the first EU market to launch, and reported more than 280 active patients on Optune Pax as of June 30, 2026.7 Frank Leonard said: "This was our strongest quarter to date, with record net revenues and active patients on therapy."7
Our narrative also mentions a narrowing-and-raising of Q2 oncology guidance and growth in Kiniksa's Arcalyst revenue. Our dossier holds no filing or source document for either, so we cannot verify them and do not rely on them here.
The other side: smaller companies cutting to survive
Not every oncology company has Merck's cushion. ADC Therapeutics announced a workforce reduction "projected to deliver $10 million in annualised cost savings" and said it "maintains a cash runway into 2028, supporting ongoing regulatory and clinical plans for ZYNLONTA combinations."8 The way to read that is simple: the company is trimming costs to reach 2028 with its plans intact. Our narrative also notes a softer Q3 guidance from OPKO, but we hold no source document for it, so we leave it as unverified.
Telix offers a contrast of a different kind. It dosed the first patient in its Phase 3 LUTEON trial of TLX250-Tx, which it describes as the first radiopharmaceutical therapy to enter Phase 3 for clear cell renal cell carcinoma.9 A Phase 3 start is a cost commitment before it is a result.
AI in discovery: a promise, not yet a financial line
The AI part of the story is real but, in our records, not yet measurable in dollars. AstraZeneca's Puja Sapra describes a "lab of the future": "Where a self-driving car uses sensors and models to navigate its environment, this system uses AI to make predictions, robotic systems to execute experiments, and instruments to generate data."10 She says the company's edge is its data: "Data is our differentiator."10 She also names the obstacle: "One of the hardest problems in de novo design is predicting whether a computationally generated molecule will be safe in the human body."10 And she stresses oversight: "With more autonomous systems, human oversight remains at the heart of this approach."10
Readers should know how much weight this source can bear. It is an article by an AstraZeneca executive, and our reliability check found that 0% of its 11 checked claims held up.10 That does not mean the claims are false. It means the checks could not confirm them against an independent source. We present the quotes as what she said, not as results AstraZeneca has achieved.
How reliable is the underlying reporting?
The press-release sources vary. In our measurement, 56% of 4,956 checked claims from the NewsEOD feed carrying the Novocure and Gilead releases held up.6,7 For the feed carrying Telix, 31% of 2,927 held up.9 For the weekly roundup that reported ADC Therapeutics' job cuts, 45% of 520 held up.8 The Merck figures come from SEC filings, not those feeds, which is why they are our backbone.
What to watch
- October 24: Merck and Moderna's detailed intismeran data at ESMO, and any word on filings.3
- November 14: the FDA goal date for Summit's ivonescimab application.4
- Merck's next filing: whether cash rebuilds from Q1's $5.327 billion, whether capex resumes its climb, and whether cost of revenue keeps rising at 23-24% a year.1
- ADC Therapeutics: whether the $10 million of savings is enough to hold its stated runway into 2028.8
