Ivonescimab Outperforms Pembrolizumab in Lung Cancer Survival Trial

The study, led by Professor Caicun Zhou, tracked patients with locally advanced or metastatic NSCLC over a median follow-up of 36 months. In the intention-to-treat population, patients receiving ivonescimab monotherapy achieved a median overall survival of 30.8 months, compared to 22.6 months for those treated with pembrolizumab. This represents a 27% reduction in the risk of death, with the survival gap widening significantly by the three-year mark.

Notably, the drug showed efficacy in populations often considered high-risk for anti-VEGF therapies. Among patients with squamous cell carcinoma, including those with central tumors or vessel involvement, researchers observed no significant increase in bleeding risks. The survival benefit remained consistent across histology types, though it proved particularly striking in the PD-L1 TPS ≥50% subgroup, where the median survival threshold was not reached during the study period. These findings, following the 2025 approval of the drug in China, suggest that ivonescimab’s dual-action mechanism—combining immuno-oncology and anti-angiogenesis—provides a robust alternative to current standard-of-care PD-1 inhibitors.