Axial cam engines have been around for a very long time. One or two are even FAA certified for aircraft use. Additionally, opposed piston designs are well known and used in various applications, from trucks to submarines, to locomotives.
These variations on a theme "type" engines do work, and they can be useful. However, there are very few of these that are truly "better" than a conventional 4 stroke engine. There is always the problem of heat transfer in energy dense configurations.
Furthermore, piston ring swept area (translate: friction) is the number 1 measure of comparable engine efficiency. A large cylinder has less surface area for rings to "Sweep" vs, multiple small cylinders. This means, a large, slow turning engine is always more efficient. Nor does that large, slow turning engine have to be heavy. Parts can be quite light and power to weight, excellent.
The "antiquated" 215HP, lightweight engine below is as efficient as a modern Prius. This is intentional, and the methods well understood from the 1930's on.