Merck & Co. reported Q1 sales of $16.3 billion, up 5% year over year, as oncology demand led by Keytruda boosts cancer franchise growth enough to offset declines in vaccines and diabetes medicines. Keytruda sales rose 12% to $8 billion, helping Merck raise the low end of its 2026 revenue guidance by $300 million to a range of $65.8 billion to $67 billion.

Why It Matters To Oncology

• Keytruda remains Merck’s core growth engine, with its newer subcutaneous formulation, Keytruda Qlex, contributing $128 million and adding momentum as the company pushes broader use in bladder and ovarian cancer.

• Welireg, Merck’s kidney cancer therapy, grew 45% to $199 million, signaling additional oncology depth beyond PD-1.

• Merck is also advancing its next-wave oncology pipeline, including PD-1/VEGF bispecific MK-2010 and potential combinations with sacituzumab tirumotecan after encouraging early data presented at AACR.

The Financials

• Total Q1 sales were $16.3 billion, up 5% from a year earlier.

• Gardasil/Gardasil 9 fell 19% to $1.1 billion, driven largely by weaker demand in China and Japan.

• Diabetes mellitus medicines were also a drag on the quarter, though oncology and newer products helped absorb the pressure.

• Outside oncology, Winrevair posted $525 million in sales, up 88% year over year and ahead of analyst expectations of $499 million, while Ohtuvayre contributed $131 million, below expectations of $158 million.

What They're Saying

• Leerink Partners analyst Daina Graybosch said subcutaneous Keytruda-based regimens are unlikely to qualify for biosimilar substitution and would need to be carved out for reimbursement.

• Research chief Dean Yi said Merck is eager to move PD-1/VEGF forward, adding that if it outperforms Keytruda, the company has many agents that could benefit from combination strategies.

• CEO Rob Davis said Merck continues to rely on business development to help fill pipeline gaps, typically targeting deals in the $1 billion to $15 billion range while staying open to larger transactions.

What's Next

• Clinicians and drug developers will be watching uptake of Keytruda Qlex, especially as Merck seeks to expand its role across tumor types and combination regimens.

• Upcoming clinical readouts for MK-2010 and its possible pairing with sacituzumab tirumotecan could shape how Merck prepares for the post-Keytruda era.

• Further demand trends in vaccines and DM, alongside execution in newer launches, will determine how much room oncology has to keep carrying overall growth.