This Thanksgiving investors are thankful that the S&P 500 is up about 15% year to date, with that path expected to continue to the end of the year.

Writing for The Motley Fool, Cory Renauer discusses some of the most well-performing biotech companies over the past year. 

His first nod goes to Loxo Oncology, who develops targeted therapies for cancer. Renauer said, “Earlier this year, Merck’s Keytruda earned the first FDA approval for a cancer indication that doesn’t specify a body part, and Loxo’s lead candidate is headed down the path the big pharma helped clear. Larotrectinib shrank tumours for a stunning 38 out of 50 patients with a variety of cancers that exhibit one genetic aberration in common, tropomyasin receptor kinase (TRK) fusions.”

Only last week, the company secured a global collaboration deal with Bayer to develop and commercialise larotrectinib and LOXO-195.Under the deal, Loxo will receive a $400 million upfront payment and a potential $450m in milestone payments after larotrectinib regulatory approvals and commercial sales events, as well an additional $200m in milestone payments for LOXO-195. 

With the FDA having already given it a breakthrough designation, it’s very possible that the drug will be approved in late 2018. 

Nektar, headquartered in San Francisco, already harbour an impressive program for cancer, auto-immune diseases and chronic pain, making it eligible for the list. 

With its partner, Bristol-Myers Squibb, the company announced positive data from the PIVOT-O2 Phase I/II trial to evaluate Bristol-Myers’ Opdivo with Nektar’s NKTR-214. The early results were presented at the 2017 Society for Immunotherapy of Cancer (SITC) Annual Meeting. 

During this year alone, the company’s stock has gained 250%. In addition, earlier in the year it reported positive results for NKTR-181, a compound that reduces chronic back pain without the “high” that causes opioid addiction. Long-term safety data is also expected by the end of the year. 

Renauer believes that if approved as a combo treatment, NKTR-214 has the potential to create more than $1 billion in annual sales for Nektar. 

Lastly, commercial stage biotech company, Spectrum who’s focus is on hematology/oncology, has grown their stock by 482% this year. This is largely due to trial data for the company’s poziotinib from 11 patients who were treated with lung cancer. 

“Spectrum’s poziotinib thrilled investors because it looks like a potential solution to a family of genetic mutations that help tumours resist popular therapies that inhibit epidermal growth factor receptor (EGFR) activity. AstraZeneca launched Tagrisso to help patients overcome one type of EGFR inhibitor resistance just two years ago, and sales of the drug are already on a $1b annualised run rate.”

Despite Poziotinib appearing to boost Tagrisso’s effectiveness, a lot could go wrong between early trials and final approval. 

Renauer concludes, “Reports of tumour shrinkage among all 11 patients treated should convince the FDA to sign off on a pivotal trial for poziotinib, but it looks like the company isn’t going to wait for a meeting with regulators. Spectrum recently started an 87-patient trial that looks suspiciously similar to studies that have led to accelerated approvals of breakthrough cancer therapies in recent years. If the FDA later decides to allow the new trial to support an application, poziotinib could be ready to launch as soon as the end of next year, although sometime in early 2020 would be reasonable.”