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HONG KONG, Nov. 2, 2025 /PRNewswire/ — Akeso (9926.HK) announced that its first-in-class bispecific antibody, ivonescimab (PD-1/VEGF bispecific antibody), in combination with chemotherapy for first-line treatment of triple-negative breast cancer (TNBC) has been granted Breakthrough Therapy Designation (BTD) by the Center for Drug Evaluation (CDE) from China’s National Medical Products Administration (NMPA).
The Phase III multicenter, randomized, double-blind clinical trial (HARMONi-BC1/AK112-308) for this combination therapy is ongoing in China. The BTD designation is expected to further expedite the clinical development and regulatory approval process of ivonescimab for the treatment of TNBC. This marks the fourth BTD granted by the CDE for ivonescimab. The previous three designations include:
Receiving four Breakthrough Therapy Designations affirms ivonescimab’s substantial clinical benefit across multiple major cancer types and reinforces Akeso’s commitment to addressing critical unmet medical needs. The therapy is currently advancing in 14 Phase III clinical trials worldwide, including four international multicenter studies. These large pivotal studies, backed by repeated regulatory recognition, position ivonescimab to deliver transformative, life-saving outcomes for patients worldwide.
Forward-Looking Statement of Akeso, Inc.
This announcement by Akeso, Inc. (9926.HK, “Akeso”) contains “forward-looking statements”. These statements reflect the current beliefs and expectations of Akeso’s management and are subject to significant risks and uncertainties. These statements are not intended to form the basis of any investment decision or any decision to purchase securities of Akeso. There can be no assurance that the drug candidate(s) indicated in this announcement or Akeso’s other pipeline candidates will obtain the required regulatory approvals or achieve commercial success. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements.
Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in P.R.China, the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; Akeso’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the Akeso’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions.
Akeso does not undertake any obligation to publicly revise these forward-looking statements to reflect events or circumstances after the date hereof, except as required by law.
About 依达方 ® (PD-1/VEGF Bispecific, Ivonescimab)
Ivonescimab is a first-in-class, PD-1/VEGF bispecific immuno-oncology agent developed by Akeso. In May 2024, it received approval from the China National Medical Products Administration (NMPA) for the treatment of locally advanced or metastatic non-squamous non-small cell lung cancer (nsq-NSCLC) after EGFR-TKI therapy. This approval made ivonescimab the world’s first bispecific antibody based on a synergistic “immunotherapy plus anti-angiogenesis” mechanism. In November 2024, ivonescimab was also included in China’s National Reimbursement Drug List (NRDL).
Additionally, ivonescimab has been approved as a first-line treatment for advanced NSCLC with positive PD-L1 expression. In the Phase III HARMONi-2 study, ivonescimab demonstrated superior efficacy compared to pembrolizumab, resulting in significantly improved clinical outcomes.
In 2025, the final overall survival (OS) analysis from the HARMONi-A study showed that ivonescimab met the OS endpoint, providing clinically meaningful and statistically significant OS benefits. As the first final OS analysis in a Phase III trial of ivonescimab, these results reaffirm the agent’s groundbreaking value in both progression-free survival (PFS) and overall survival for patients. Moreover, a head-to-head Phase III trial comparing ivonescimab plus chemotherapy to tislelizumab plus chemotherapy in first-line treatment for squamous NSCLC also yielded promising results. These findings position ivonescimab as a substantial clinical breakthrough whether in comparison to PD-1 monotherapy in immuno-oncology, the current standard of care (SOC) of PD-1 inhibitors combined with chemotherapy, or VEGF-targeted therapies in the anti-angiogenesis field. This underscores ivonescimab’s significant potential in cancer treatment.
As ivonescimab continues to demonstrate substantial clinical value and the potential to redefine treatment standards, its presence in key immuno-oncology indications is expanding rapidly. In lung cancer, the most prevalent cancer globally, ivonescimab is currently involved in 8 registrational/Phase III clinical studies, including:
In other major tumor types, ivonescimab is rapidly advancing first-line indications with ongoing Phase III trials in:
In the challenging area of cold tumors, ivonescimab has received its fourth Breakthrough Therapy Designation for first-line triple-negative breast cancer. Additionally, Phase III studies are underway for first-line MSS/pMMR colorectal cancer (which accounts for 95% of CRC cases) and first-line pancreatic cancer. Further Phase III studies are also being prepared.
With nearly 20 Phase II studies across more than 10 additional indications, ivonescimab has established a robust data foundation to support the rapid global expansion of Phase III trials.
About Akeso
Akeso (HKEX: 9926.HK) is a leading biopharmaceutical company committed to the research, development, manufacturing and commercialization of the world’s first or best-in-class innovative biological medicines. Founded in 2012, the company has created a unique integrated R&D innovation system with the comprehensive end-to-end drug development platform (ACE Platform) and bi-specific antibody drug development technology (Tetrabody) as the core, a GMP-compliant manufacturing system and a commercialization system with an advanced operation mode, and has gradually developed into a globally competitive biopharmaceutical company focused on innovative solutions. With fully integrated multi-functional platform, Akeso is internally working on a robust pipeline of over 50 innovative assets in the fields of cancer, autoimmune disease, inflammation, metabolic disease and other major diseases. Among them, 24 candidates have entered clinical trials (including 15 bispecific/multispecific antibodies and bispecific ADCs. Additionally, 7 new drugs are commercially available. Through efficient and breakthrough R&D innovation, Akeso always integrates superior global resources, develops the first-in-class and best-in-class new drugs, provides affordable therapeutic antibodies for patients worldwide, and continuously creates more commercial and social values to become a global leading biopharmaceutical enterprise.
For more information, please visit https://www.akesobio.com/en/about-us/corporate-profile/ and follow us on Linkedin.
SOURCE Akeso, Inc.


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The Evolution trial (WJOG11819L) was designed to test whether radiotherapy could be safely omitted in selected patients with unresectable, locally advanced non-small-cell lung cancer (NSCLC) exhibiting high PD-L1 expression (TPS ≥50%). This patient population represents an immunologically distinct subgroup known to derive substantial benefit from PD-1 blockade, as demonstrated in prior pivotal studies such as KEYNOTE-024, -042, -189, and -407, which established pembrolizumab-based regimens as the foundation of systemic therapy in advanced NSCLC.
In this phase 2, multicentre, single-arm study, investigators sought to determine whether pembrolizumab combined with platinum-based chemotherapy, administered without radiotherapy, could achieve durable disease control and survival outcomes comparable to the standard chemoradiotherapy followed by durvalumab consolidation used in the PACIFIC trial. The rationale was to explore a radiotherapy-free, chemoimmunotherapy approach that could reduce treatment-related toxicities such as pneumonitis and esophageal injury—complications that frequently limit the feasibility of curative-intent chemoradiation and preclude up to one-third of patients from receiving consolidation immunotherapy.
This multicentre, single-arm, phase 2 trial was conducted across nine Japanese centers under the West Japan Oncology Group (WJOG).
Eligible patients were adults (≥20 years) with unresectable, locally advanced stage IIIA–IIIC NSCLC, PD-L1 TPS ≥50%, ECOG performance status 0–1, and no prior systemic therapy. All had an indication for definitive chemoradiotherapy but received a radiotherapy-free regimen instead.
Induction therapy (4 cycles): Pembrolizumab 200 mg every 3 weeks + platinum-based doublet chemotherapy
Maintenance therapy: Pembrolizumab (± pemetrexed) every 3 weeks for up to 2 years.
Between May 18, 2020, and February 22, 2022, a total of 21 patients were enrolled in the Evolution trial. The median age was 73 years, and 76% were male. All patients received pembrolizumab combined with carboplatin-based chemotherapy, followed by maintenance pembrolizumab. Nearly half of the patients (48%) were able to complete the full 2-year course of maintenance therapy. The median follow-up period was 32.5 months, allowing for mature outcome assessment.
The primary endpoint was met, demonstrating strong and durable disease control:
The 2-year progression-free survival (PFS) rate was 67% (90% CI 46–83).
The median PFS was not reached, indicating that many patients remained progression-free at data cutoff.
The median overall survival (OS) was 44.4 months (32.5–NR), with a 2-year OS rate of 81%.
Tumor response was robust. The objective response rate (ORR) was 81%, including 8 complete responses and 9 partial responses. Moreover, two-thirds of patients (67%) achieved deep responses, defined as ≥80% tumor shrinkage. These deep responders had markedly improved outcomes, with a 2-year PFS of 86% compared to 29% in non-deep responders (p = 0.0173), suggesting a strong association between depth of response and long-term disease control.

Efficacy appeared closely related to the level of PD-L1 expression:
In patients with PD-L1 TPS 80–100%, the 2-year PFS was 75%, OS was 92%, and ORR reached 92%.
In contrast, those with PD-L1 TPS 50–79% had lower rates—PFS 56%, OS 67%, and ORR 67%.
These findings indicate that patients with ultra-high PD-L1 expression (≥80%) experienced the greatest and most durable benefit, reinforcing PD-L1 TPS as a predictive biomarker for selecting candidates who may achieve long-term remission with this radiotherapy-free chemoimmunotherapy approach.
All 21 patients in the Evolution trial experienced at least one adverse event during treatment, reflecting the expected toxicity profile of combination chemoimmunotherapy. Grade 3 or higher adverse events occurred in 62% of patients, while serious adverse events were reported in 33%. The most frequently observed severe toxicities were neutropenia (38%), leukopenia (19%), and pneumonia (14%), which were consistent with known effects of platinum-based chemotherapy.
Immune-related adverse events (irAEs) were documented in 33% of patients, with grade 3 or higher events in 14%. The most common immune-mediated toxicities included pneumonitis (10%), adrenal insufficiency (5%), and colitis (10%). Importantly, these immune-related events were manageable with corticosteroids and treatment interruption, and no treatment-related deaths were reported.
Overall, 24% of patients discontinued therapy due to adverse events; however, an intriguing observation emerged—three patients who stopped treatment because of immune-related toxicities, such as grade 2–3 pneumonitis or colitis, continued to experience durable disease control lasting beyond two years. This finding supports the concept that a strong immune response, even when accompanied by immune-related toxicity, may correlate with sustained anti-tumor activity and long-term remission in patients treated with immune checkpoint inhibitors.
The Evolution trial provides the first prospective evidence supporting a radiotherapy-free, chemoimmunotherapy approach in unresectable, locally advanced NSCLC with high PD-L1 expression.
Pembrolizumab combined with platinum doublets achieved 2-year PFS and OS rates comparable or superior to historical chemoradiotherapy data with durvalumab consolidation (PACIFIC trial: ~50% 2-year PFS).
The durable responses and survival plateaus observed, particularly among deep responders and PD-L1 ≥80%subgroups, indicate potential curative intent with systemic immunochemotherapy alone.
This approach could represent a less toxic alternative for patients at high risk of radiation-induced morbidity or those ineligible for concurrent chemoradiotherapy. However, the single-arm design and small sample size necessitate randomized validation against the PACIFIC regimen.

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