Healthcare sat out a broad rally: XLV closed flat at 0.0% against the S&P 500's +0.7%, while XBI (+0.6%) and NBI (+0.4%) edged up and BBC slipped (0.4%). Single names traded on pre-open news, with Oruka higher on its 07:00 ET psoriasis readout and Moderna down about 7% premarket on fresh intismeran detail.

Tech led after Anthropic filed for a Nasdaq listing before the open: Nasdaq 100 +1.1%, S&P 500 +0.7%, Russell 2000 +0.4%, Dow +0.3%. Brent settled 0.8% lower at $115.81 as Middle East diplomacy resumed, and the 10-year held just under 5% into the two-day FOMC, which decides on Wednesday.

Merck and Kelun-Biotech's TROP2 ADC sac-TMT cut the risk of death 32% versus chemotherapy in the Phase 3 TroFuse-005 trial in previously treated advanced or recurrent endometrial cancer, extending median survival by 6.9 months (19.0 vs 12.1). Progression risk fell 41% (median PFS 7.2 vs 3.9 months); the data were presented at ESMO and published in The Lancet.

Why it matters: TroFuse-005 is the first of Merck's 18 global sac-TMT Phase 3s to read out: Western patients behaving like the Chinese datasets that justified the whole program. In roughly 776 patients already through platinum and a PD-(L)1, ORR doubled to 35.1% from 17.3%. The cost is tolerability, with severe treatment-related events at 54.4% versus 41.4%. The FDA has set a 15 June 2027 action date, which a national priority voucher could pull forward. Leerink sees $1.5B of gynecologic sales by 2033, only a sixth of its peak, so the Keytruda-2028 replacement case still rests on lung, where Gilead's Trodelvy looked far better in China than in the West.

Source: STAT

More: Fierce Pharma; BioSpace

Genmab's FRα-directed ADC rinatabart sesutecan (Rina-S) met its primary endpoint in the 584-patient Phase 3 RAINFOL-02 in platinum-resistant ovarian cancer, cutting the risk of progression or death 71% versus investigator's-choice chemotherapy (HR 0.29) and the risk of death 57% (OS HR 0.43), regardless of FRα expression. Genmab released topline results on Friday without medians or adverse-event rates.

Why it matters: RAINFOL-02 turns Rina-S from a strong Phase 2 cohort into a registrational asset, and the effect sizes are unusually large for platinum-resistant disease: OS HR 0.43 against chemo, versus 0.67 for AbbVie's Elahere in MIRASOL, cross-trial. Elahere is confined to FRα-high tumours; the 492-patient primary analysis set here, which leans on lower-FRα and Elahere-pretreated patients, held the effect (PFS HR 0.33, OS HR 0.44), so the label could reach the whole PROC population. What is missing is everything below the hazard ratios: no medians, no toxicity rates, no filing date, with full data held for a later meeting. Genmab's investor update on Wednesday 28 Oct is the next chance for numbers.

Source: Fierce Biotech

More: Genmab

AstraZeneca's sonesitatug vedotin (sone-ve), a claudin 18.2 ADC, cut the risk of death 42% versus investigator's choice in second-line and later claudin 18.2-positive gastric and GEJ cancer in the global Phase 3 CLARITY-Gastric01 (n=532; median OS 10.6 vs 6.4 months), with grade 3+ treatment-related events at 36.4% versus 44.8%. It missed the BICR-assessed PFS co-primary (HR 0.77, p=0.053).

Why it matters: This is the first global Phase 3 for a claudin 18.2 ADC, and the survival case is clean: HR 0.58 overall and 0.47 in third line or later, where median OS doubled to 10.0 from 5.0 months. The soft spot is PFS, a 0.4-month median gap by central read that AZ blames on hard-to-measure peritoneal disease, so the label debate will turn on whether OS alone carries it. The class is filling fast: Takeda and Innovent's claudin ADC posted a 10.2-month OS at the same meeting, and Astellas' Vyloy already owns first line with chemo, which AZ is chasing in CLARITY-Gastric02. Sone-ve came from China's KYM Biosciences in 2023; licences sit outside Treasury's draft outbound rules.

Source: Fierce Biotech

More: Endpoints; AstraZeneca

Pfizer's Talzenna plus Xtandi won FDA approval in HRR-mutated metastatic hormone-sensitive prostate cancer, the first PARP inhibitor cleared in that setting, after TALAPRO-3 cut the risk of radiographic progression or death 52% versus Xtandi alone; grade 3+ anemia hit 51%. — Fierce Pharma

BioNTech and DualityBio's HER2 ADC trastuzumab pamirtecan met its PFS primary in the 541-patient DYNASTY-Breast02 Phase 3 in HR+/HER2-low breast cancer, but the partners called the gain modest, flagged more lung inflammation than in earlier trials and are reviewing next steps. — Endpoints

Incyte's KRAS G12D inhibitor INCB161734 posted an 81% confirmed ORR with FOLFIRINOX in first-line pancreatic cancer (n=28), level with RevMed's zoldonrasib, and heads into a Phase 3 that reads out in 2028. — Fierce Biotech

Oruka's long-acting IL-23 antibody ORKA-001 hit 61% PASI 100 at week 16 on 600mg versus 0% on placebo in the 187-patient Phase 2b EVERLAST-B psoriasis trial, with responders moving to once-yearly dosing; Phase 3 starts in 1H27. — Dermatology Times

Tango is cutting about 14% of its workforce, mostly in research, to focus on vopimetostat, and plans a registrational Phase 3 with RevMed's Rasonque in first-line MTAP-deleted pancreatic cancer in 1H27, with no supply deal yet. — Fierce Biotech

Roche's shifting giredestrant launch plans show how MFN pricing is changing the order of European drug launches. — Endpoints

WuXi AppTec raised its 2026 revenue forecast again while it fights its Department of Defense designation in court. — Endpoints

No notable M&A or licensing deals were announced since yesterday.

No notable private financings were identified in the last 24 hours.

Corxel will take its US unit public on Nasdaq by merging with Amanat Acquisition Corp., backed by a ~$300M PIPE (RTW, NEA, SR One, TCGX, RA Capital, Invus et al) plus ~$75M in trust, to fund a global Phase 3 of oral GLP-1 CX11 (up to 11.5% weight loss at 36 weeks in Phase 2); close expected 1H27. — Endpoints

Aspen Neuroscience (autologous cell therapy, Parkinson's) and Bambusa (bispecific antibodies) are each targeting $135M IPOs. — Endpoints

Zai Lab (ZLAB) sold ~$250M in a PIPE, 11.34M ADSs at $22.04, led by TCGX with RA Capital, RTW, Wellington, Cormorant and others, to fund global development of DLL3 ADC zocilurtatug pelitecan; closing 27 Oct. — Zai Lab 8-K

Phase 2 MDT-BRIDGE data showed neoadjuvant durvalumab plus chemotherapy enabled surgery in most resectable or borderline resectable NSCLC patients. — Nature Medicine

Nature Reviews Drug Discovery examined strategies for restoring antibiotic efficacy. — Nature RDD