Summit Therapeutics, once a beacon of hope for antibiotic-resistant infections, seems to be shifting gears. While their Q1 2024 earnings call focused on ivonescimab, a PD-1/VEGF bispecific antibody for cancer treatment, their historically core focus – antibiotics – was noticeably absent. This raises a critical question: is Summit subtly transitioning from its roots in anti-infectives to embrace the lucrative world of oncology?

The transcript of the call reveals a striking absence of any mention of SMT-738, their novel precision antibiotic. This stands in stark contrast to previous calls where SMT-738, particularly its potential against carbapenem-resistant Enterobacteriaceae infections, was a significant part of the discussion.

This silence is particularly noteworthy given the ongoing global crisis of antibiotic resistance. The World Health Organization has labeled it one of the biggest threats to global health [WHO Fact Sheet](https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance), underscoring the dire need for new, effective antibiotics. Summit, with its innovative SMT-738, was positioned to play a crucial role in this fight.

However, the Q1 2024 earnings call suggests a shift in priorities. The company's narrative has pivoted towards showcasing ivonescimab's potential in tackling various forms of cancer. Maky Zanganeh, CEO and President of Summit, dedicated a considerable portion of his address to highlighting the ongoing Phase III trials for ivonescimab in non-small cell lung cancer, emphasizing its "cooperative binding" mechanism and promising Phase II data.

The focus on ivonescimab's potential beyond lung cancer further reinforces this hypothesis of a strategic shift. Zanganeh discussed plans for exploring its application in other solid tumors, including gynecological tumors, head and neck cancer, triple-negative breast cancer, and colorectal cancer. This expansive ambition in oncology is a clear indicator of where Summit is placing its bets.

Financial figures presented by Manmeet Soni, COO and CFO, further support this notion. While emphasizing the company's robust cash position and extended runway, Soni highlighted research and development spending dedicated to "clinical development of ivonescimab, including clinical trials and technology transfer." This suggests a significant allocation of resources towards advancing ivonescimab, potentially at the expense of their antibiotics program.

While Summit's interest in oncology is understandable, the potential abandonment of their antibiotics research raises concerns. SMT-738, with its unique mechanism of action and targeted approach, holds immense promise in addressing the growing threat of antibiotic resistance.

Oncology vs. Antibiotics: The Financial Landscape

The financial allure of oncology is undeniable. The global oncology market is projected to reach $439.4 billion by 2027 [Source](https://www.globenewswire.com/news-release/2020/08/05/2073559/0/en/Global-Oncology-Market-to-Reach-439-4-Billion-by-2027-Amid-the-COVID-19-Crisis-Says-Arriveat-Market-Research.html), fueled by an aging population and the increasing incidence of cancer. This presents a lucrative opportunity for biopharmaceutical companies. In contrast, the antibiotics market faces challenges due to pricing pressures and the complexities of developing new drugs.

Mentions of Ivonescimab vs. SMT-738 in Earnings Calls

The shift in Summit's focus is evident in the number of times ivonescimab and SMT-738 were mentioned in recent earnings calls.

It's important to note that Summit hasn't explicitly announced any discontinuation of its antibiotics program. However, the complete omission of SMT-738 from their recent earnings call, coupled with their enthusiastic pursuit of ivonescimab, raises compelling questions about their long-term commitment to fighting antibiotic resistance.

This silence could be a calculated move. Perhaps Summit is waiting for more mature Phase II data for ivonescimab before making pronouncements about its antibiotic program. They may also be strategically downplaying their antibiotics research to attract investors more interested in oncology.

Whatever the underlying reason, the shift in Summit's narrative is evident. While their future in antibiotics remains uncertain, their ambition in oncology is clear. Can Summit strike a balance between pursuing the financial rewards of oncology and fulfilling its initial mission of combating the urgent global threat of antibiotic resistance? Or is this a silent shift, where Summit leaves behind its antibiotic legacy for a future dominated by cancer therapeutics?

"Fun Fact: The discovery of penicillin, the first antibiotic, was a serendipitous event. In 1928, Alexander Fleming returned from a holiday to find that a mold had contaminated his petri dishes, inhibiting the growth of bacteria. This accidental discovery revolutionized medicine and ushered in the era of antibiotics."