PD-(L)1 x VEGF Competitive Landscape: 100 Programs, One Approved Drug

Western pharma is licensing PD-(L)1 x VEGF drugs from China, not building them

Western pharma is licensing PD-(L)1 x VEGF drugs from Chinese originators rather than building its own, through five deals worth more than $30 billion. Sleuth’s April 2026 snapshot counts 100 programs across all phases, and only one, ivonescimab, has reached approval, in non-small cell lung cancer (NSCLC) in China. The five deals pair Summit and Akeso (ivonescimab), BMS and BioNTech, AbbVie and RemeGen, Pfizer and 3SBio, and Merck and LaNova.

Bispecific antibodies lead today, while new formats fill the early pipeline

Of the 100 programs in the April 2026 snapshot, 26 are at IND stage or later, 53 are preclinical and the other 21 were identified from patent filings, are undisclosed or were excluded on editorial review. Bispecific antibodies account for the sole approval and three of the four Phase 3 programs, with a fusion protein the fourth, but only 21 of the 53 preclinical programs. Trispecific antibodies (11 preclinical), fusion proteins (10) and ADCs (4) are diversifying the early pipeline, and most preclinical programs are single-company efforts without licensing partners.

Early sponsors are building positions before seeking deals, which signals broad conviction in the mechanism and a steady supply of future licensing candidates.

NSCLC is the battleground, and HCC is still open at Phase 3

Among the 26 clinical-stage programs in Sleuth’s April 2026 snapshot, NSCLC is the primary battleground, with 16 active competitors. Colorectal and liver cancer (HCC) tie at 12 programs each, but HCC has no Phase 3 trials, leaving it a wider window than colorectal cancer. Mid-tier indications cluster at seven to nine competitors each.

A sponsor entering now has a better chance of a first-to-pivotal position in HCC than in NSCLC.

Ivonescimab sets the class timeline

Ivonescimab beat pembrolizumab head to head in China’s HARMONi-2 trial and was set to generate four readouts by mid-2027, about 18 months of data flow before any competitor reports pivotal data. Since the snapshot, the squamous-cohort interim PFS analysis of the global HARMONi-3 trial did not meet its threshold for statistical significance in the second quarter of 2026, and the trial continues to a final PFS analysis expected in the second half of 2026. In China, the HARMONi-6 trial showed an overall survival benefit for ivonescimab with chemotherapy over tislelizumab with chemotherapy in first-line squamous NSCLC (hazard ratio 0.66, presented in May 2026), and in August 2026 China’s regulator approved that combination, ivonescimab’s third approval there. The FDA has set a November 14, 2026 decision date for ivonescimab with chemotherapy in EGFR-mutated non-squamous NSCLC after EGFR TKI treatment. Pfizer’s SSGJ-707 has the only other 2026 readout, as a China-only monotherapy trial, and BMS and BioNTech’s pumitamig is not expected to report global Phase 3 PFS until late 2028 or 2029.

The class re-rates on ivonescimab’s global data, so the final HARMONi-3 analysis and the November FDA decision are the events to watch.

Programs, deals and catalysts are as of April 2026. HARMONi-3, HARMONi-6, China approval and FDA review status are current as of September 2026.

Frequently asked questions about PD-(L)1 x VEGF bispecifics

How many PD-(L)1 x VEGF drugs are in development?

Sleuth tracked 100 programs as of April 2026: 26 at IND stage or later, 53 preclinical and the other 21 identified from patents, undisclosed or excluded on review. Only ivonescimab is approved, in China, where it gained a first-line squamous NSCLC approval in August 2026.

Which companies have licensed PD-(L)1 x VEGF drugs?

Summit (ivonescimab from Akeso), BMS (with BioNTech), AbbVie (from RemeGen), Pfizer (from 3SBio) and Merck (from LaNova), across five deals worth more than $30 billion.

What is the status of ivonescimab in the US?

The FDA has set a November 14, 2026 decision date for ivonescimab with chemotherapy in EGFR-mutated non-squamous NSCLC after EGFR TKI treatment. The HARMONi-3 interim PFS analysis in squamous NSCLC missed its threshold, and the final analysis is expected in the second half of 2026.

Which cancers are PD-(L)1 x VEGF drugs targeting?

Among the 26 clinical-stage programs as of April 2026, NSCLC leads with 16 competitors, followed by colorectal and liver cancer with 12 each. Liver cancer had no Phase 3 trials.