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Real World Cases

2.5.1- Johnson and Johnson

Johnson & Johnson has become one of the most dominant
players in oncology—not by curing cancer, but by
mastering how to manage it over time. Nowhere is this
clearer than in multiple myeloma, a blood cancer
characterized by relapse, resistance, and relentless
treatment escalation. In this space, J&J doesn’t offer a
single solution. It offers a franchise.

First came Darzalex® (daratumumab), a monoclonal
antibody targeting CD38—a surface protein found on
myeloma cells. Approved in 2015, it rapidly became the
standard of care for newly diagnosed and relapsed patients
alike. Sales soared past $9 billion annually. But as with all
biologics, durability was not guaranteed. Over time,
patients progressed. The immune system adapted.
Resistance emerged.

Rather than engineer a more durable version or invest in
strategies to prevent immunologic escape, Johnson &
Johnson took another path: they expanded the portfolio.

In 2022, they introduced Carvykti® (ciltacabtagene
autoleucel), a CAR-T cell therapy targeting BCMA. Then
Talvey® (talquetamab)—a bispecific antibody targeting
GPRC5D—entered the scene in 2023. Each one is designed
for the next step in a patient’s treatment journey. Not a
replacement. A follow-up. A commercial answer to
biologic failure.

This isn’t innovation by accident. It’s a strategy.

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