Ivonescimab, a pioneering PD-1/VEGF bispecific antibody developed by Akeso, Inc., secured approval from China’s National Medical Products Administration (NMPA) on April 25, 2025, for first-line treatment of PD-L1-positive non-small cell lung cancer (NSCLC). This landmark Ivonescimab NMPA approval, grounded in the robust results of the AK112-303/HARMONi-2 Phase III trial, positions the therapy as a transformative option in oncology. By outperforming pembrolizumab, a standard PD-1 inhibitor, ivonescimab delivers superior progression-free survival (PFS) and a promising overall survival (OS) trend, offering a chemotherapy-free alternative that could redefine NSCLC management for patients and healthcare systems.

Unprecedented Efficacy in the HARMONi-2 Trial

The AK112-303/HARMONi-2 trial, a randomized, double-blind study, directly compared ivonescimab monotherapy against pembrolizumab in patients with locally advanced or metastatic PD-L1-positive NSCLC (TPS ≥1%) without EGFR or ALK mutations. Ivonescimab achieved a median PFS of 11.14 months, compared to 5.8 months for pembrolizumab, yielding a hazard ratio (HR) of 0.51 (95% CI, 0.38-0.69; P < .0001). This 49% reduction in the risk of disease progression or death underscores the therapy’s potency. Additionally, an interim OS analysis, requested by the NMPA, revealed a 22.3% lower risk of death (HR = 0.777) with ivonescimab, signaling a clinically meaningful survival trend. These results, published in The Lancet, establish ivonescimab as the first therapy to surpass pembrolizumab in a head-to-head NSCLC trial, reinforcing the significance of the Ivonescimab NMPA approval.

Innovative Dual-Action Mechanism

Ivonescimab’s unique design combines PD-1 blockade with VEGF inhibition in a single molecule, merging immunotherapy’s immune activation with anti-angiogenesis’ tumor microenvironment modulation. This dual mechanism enhances efficacy in PD-L1-positive NSCLC by targeting both immune checkpoints and tumor vasculature. Unlike traditional combination therapies, ivonescimab’s cooperative binding properties increase affinity for PD-1 in the presence of VEGF, potentially improving outcomes in tumor tissue while minimizing off-target effects. The Ivonescimab NMPA approval marks the global debut of a bispecific antibody with this dual cancer immunotherapy and anti-angiogenesis approach, setting a new benchmark for NSCLC treatment.

Strategic Implications for Market Access and Public Policy

The Ivonescimab NMPA approval carries profound implications for market access and health economics. As a chemotherapy-free regimen, ivonescimab reduces treatment complexity. This potentially lowers healthcare costs associated with prolonged hospital stays and adverse event management. Its favorable safety profile, comparable to pembrolizumab with manageable VEGF-related toxicities like hypertension and proteinuria, enhances patient quality of life. This approval highlights an opportunity to integrate innovative therapies into reimbursement frameworks, ensuring equitable access for NSCLC patients. The therapy’s success may also prompt regulatory agencies worldwide to prioritize bispecific antibodies, accelerating approvals for similar agents.

Driving Research and Global Standards

The Ivonescimab NMPA approval accelerates research into bispecific antibodies across oncology. Akeso is advancing ivonescimab in over 12 Phase III trials for cancers including lung, breast, and colorectal. These studies are building on its prior approval in China for EGFR-mutant NSCLC post-TKI failure. This versatility underscores its potential across diverse indications. Summit Therapeutics, Akeso’s partner, is conducting the HARMONi-7 trial to validate ivonescimab in Western populations. Positive results could redefine global NSCLC treatment guidelines, establishing ivonescimab as a cornerstone therapy. Harmonizing data from these global trials will be critical to support its broader adoption and influence on international standards.

Conclusion: A Global Horizon for NSCLC Care

The Ivonescimab NMPA approval heralds a new era in NSCLC treatment, blending cutting-edge science with tangible patient benefits. Its superior efficacy and chemotherapy-free approach promise to enhance outcomes while addressing cost and access challenges. As Akeso and Summit pursue global trials, others must prepare for ivonescimab’s potential to redefine care standards worldwide. Aligning reimbursement policies and streamlining regulatory pathways are critical next steps to ensure equitable access to ivonescimab. This will drive broader adoption and transformative impact in oncology.

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