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The relentless march of VEGF bispecifics

Two new pivotal Chinese first-line trials have started in lung cancer.

The PD-(L)1 x VEGF field continues to expand at a rapid pace, with new players and trials emerging almost every month, especially in non-small cell lung cancer.

In just the last two weeks, two more pivotal studies have been posted on the clinicaltrials.gov registry for this indication. The latest entries come from Sinocelltech and Huabo, two Chinese companies that, for now at least, have not scored a partnership with big pharma.

The first of these two studies evaluates Sinocelltech’s PD-1 x VEGF bispecific SCTB14 in first-line NSCLC. The pivotal trial will enrol both squamous and non-squamous patients with PD-L1 expression of 10% or higher and no actionable driver mutations. SCTB14 will be tested head to head against Keytruda, with progression-free survival as a primary endpoint.

Huabo, meanwhile, is expanding its late-stage footprint in NSCLC. After previously posting a pivotal trial in squamous NSCLC it has now registered a second pivotal study for its PD-L1 x VEGF fusion protein sotiburafusp alfa, in non-squamous NSCLC.

Both trials pair the experimental agent with chemotherapy, but the choice of the comparator arm differs by histology: Keytruda plus chemo in squamous, and BeOne’s Tevimbra plus chemo in non-squamous.

The difference in the comparators is notable, particularly as Akeso’s pivotal trial of its Summit-partnered contender ivonescimab in squamous NSCLC, Harmoni-6, uses Tevimbra plus chemo as control arm.

Data backing

Huabo’s confidence in moving both indications into pivotal studies rests on data presented at ESMO. 

In non-squamous NSCLC the company reported a 62% response rate among 63 treatment-naive patients treated with sotiburafusp alfa. While those numbers fell short of the 85% ORR seen in 62 squamous patients, the safety profile appeared cleaner, with no grade 5 treatment-related adverse events reported, versus two in the squamous population.

With these two additions, a total of 16 NSCLC pivotal trials evaluating PD-(L)1 x VEGF bispecifics have now been posted on clinicaltrials.gov. And the wave shows little sign of breaking, with Junshi expected to initiate a pivotal neoadjuvant study of JS207, while AbbVie and RemeGen are gearing up to move RC148 into pivotal testing in the first and second-line settings. 

 

Selected PD-(L)1 x VEGF bispecific pivotal studies in first-line NSCLC

TrialSponsorIndicationRegimenStatus
Rosetta-Lung02*BioNTech1st-line, PD-L1 all comersPumitamig + chemo, vs Keytruda + chemoPhase 2 data expected in 2026
Rosetta-Lung202Bristol Myers Squibb1st-line, PD-L1 ≥50%Pumitamig, vs KeytrudaTo start Apr 2026
SCTB14-A301Sinocelltech1st-line, PD-L1 ≥10%SCTB14, vs KeytrudaStarted Dec 2025; primary completion Jul 2027
HB0025-C-0303HuaboNon-squam, 1st-lineSotiburafusp alfa + chemo, vs Tevimbra + chemoStarted Jan 2026; primary completion Apr 2028
HB0025-C-0302HuaboSquam, 1st-lineSotiburafusp alfa + chemo, vs Keytruda +chemoStarted Jan 2026; primary completion Apr 2028
C461001Pfizer1st-line, PD-L1 all comersPF-08634404 + chemo, vs Keytruda + chemoStarted Jan 2026; primary completion Feb 2029
SSGJ-707-NSCLC-III-013Sbio1st-line, PD-L1 ≥1%PF-08634404, vs KeytrudaStarted Jun 2025; primary completion Jul 2026
Harmoni-3Summit1st-line, PD-L1 all comersIvonescimab + chemo, vs Keytruda + chemoData due H2 2026 for sq; H1 2027 non-sq
Harmoni-7Summit1st-line, PD-L1 ≥50%Ivonescimab, vs KeytrudaStarted Feb 2025; primary completion Apr 2028
Harmoni-2Akeso1st-line, PD-L1 ≥1%Ivonescimab, vs KeytrudaApproved in China Apr 2025
Harmoni-6AkesoSquam, 1st-lineIvonescimab + chemo, vs Tevimbra + chemoNDA accepted in China Jul 2025

Note: *phase 2/3. Source: OncologyPipeline.