Lung & Chest Care in China

Ivonescimab

Approved in China in May 2024, ivonescimab has demonstrated superiority over Keytruda in two separate Phase 3 lung cancer trials. In HARMONi-2 (PD-L1-positive advanced NSCLC) it more than doubled median progression-free survival versus Keytruda (11.1 vs 5.8 months; HR 0.51). In HARMONi-A (EGFR-mutant NSCLC after TKI failure) the combination improved overall survival versus chemotherapy (16.8 vs 14.1 months; HR 0.74). The FDA review is pending; today this drug is accessible only in China.

References [R9a][R9b]

Savolitinib

Co-developed by AstraZeneca and HUTCHMED and approved by the NMPA in 2021, savolitinib was the first targeted therapy in the world approved for MET exon 14 skipping mutations in NSCLC. About 3% of lung cancer patients carry this mutation — disproportionately elderly, with poor chemotherapy outcomes. The pivotal Chinese trial showed an overall response rate of 49.2% and median progression-free survival of 6.9 months in pretreated patients. In the US, Europe, and most of Asia, MET ex14-positive patients still have no approved precision treatment. China remains the only country where savolitinib is in routine clinical use, with multi-year real-world experience at Shanghai Chest, Sun Yat-sen University Cancer Center, and other major thoracic centers.

References [R10]

Furmonertinib

Approved by the NMPA in 2021, furmonertinib is a third-generation EGFR inhibitor specifically designed for EGFR-mutant NSCLC patients with brain metastases. Its superior CNS penetration addresses one of the hardest challenges in lung cancer — controlling disease in the brain while treating the primary tumor. The FURLONG Phase 3 trial showed a median progression-free survival of 20.8 months versus 11.1 months for gefitinib (HR 0.44) — among the strongest first-line EGFR data ever published from China. Approved at both low and high doses (80 mg / 160 mg), it allows dose individualization for elderly or frail patients. Not available in the US or Europe; Chinese centers have the world's largest real-world experience with this drug.

References [R11]

Ensartinib

Approved by the NMPA in 2020 — five years before the FDA — ensartinib is a China-developed next-generation ALK inhibitor. The eXalt3 Phase 3 trial enrolled 290 patients globally and demonstrated superior progression-free survival versus crizotinib (median 25.8 vs 12.7 months; HR 0.51) with strong intracranial activity. The FDA granted approval in January 2025 based on the same dataset Chinese regulators reviewed years earlier. Patients with ALK-positive NSCLC can access this drug in China with the longest real-world clinical experience anywhere in the world, anchored at Shanghai Chest, Guangdong Provincial People's Hospital, and CAMS Cancer Hospital — where Chinese clinicians led the global pivotal program.

References [R12]

Sunvozertinib

Developed entirely in China by Dizal Pharmaceuticals and conditionally approved by the NMPA in 2023, sunvozertinib targets EGFR exon 20 insertion mutations — a subtype historically resistant to all standard EGFR inhibitors, with no effective oral therapy available for years. The pivotal WU-KONG6 trial showed a 60.8% confirmed response rate with a median duration of response of 11.1 months in heavily pretreated patients. The FDA granted approval in July 2025, two years after the China approval and based on the same evidence base. Patients with EGFR exon 20 insertion NSCLC can access this therapy now in China, backed by the world's largest real-world experience in this rare mutation subtype.

References [R13]

Serplulimab

Developed by Shanghai Henlius and approved by the NMPA in January 2023, serplulimab was the world's first anti-PD-1 antibody specifically approved for first-line extensive-stage small cell lung cancer (SCLC). SCLC is one of the most aggressive cancers, with historic 2-year survival below 5% — until immunotherapy. The ASTRUM-005 Phase 3 trial enrolled 585 patients across six countries (the world's largest SCLC immunotherapy cohort) and demonstrated median overall survival of 15.4 vs 10.9 months for chemotherapy alone (HR 0.63). This drug is not approved in the US for SCLC — atezolizumab and durvalumab dominate that market — making China the only major source of serplulimab access for international SCLC patients.

References [R14]

Adebrelimab

Developed by Jiangsu Hengrui and approved by the NMPA in February 2023, adebrelimab was the second China-developed immunotherapy approved for first-line extensive-stage SCLC. The CAPSTONE-1 Phase 3 trial enrolled 462 Chinese patients and demonstrated median overall survival of 15.3 vs 12.8 months for chemotherapy alone (HR 0.72), with consistent benefit across subgroups. Two fully approved domestic SCLC immunotherapies — serplulimab from Henlius and adebrelimab from Hengrui — within one month of each other reflects the unusual depth of China's oncology pipeline in a disease the rest of the world has historically struggled to treat. No US or EU approval exists for either drug.

References [R15]

Anlotinib

Approved by the NMPA in 2019 for SCLC at third line or beyond, anlotinib is a wholly China-developed multi-target tyrosine kinase inhibitor (targeting VEGFR1-3, FGFR1-4, PDGFRα/β, and c-Kit). The ALTER-1202 trial showed a clear survival and progression-free-survival benefit versus placebo in patients who had progressed through chemotherapy and immunotherapy. Anlotinib has been approved across more than eight separate NMPA indications (NSCLC, soft-tissue sarcoma, thyroid cancer, and others), making it one of the most broadly deployed Chinese oncology drugs. For SCLC patients who have run out of standard options at home, it provides an evidence-based oral pathway available exclusively in China.

References [R16]

Single-port VATS at Shanghai Pulmonary Hospital — the world's largest minimally invasive thoracic program.

Single-port VATS is indicated for early-stage and locally advanced lung cancer requiring lobectomy, segmentectomy, or wedge resection — as well as for selected mediastinal tumors, pulmonary metastases, and bullous lung disease. It uses one small intercostal incision instead of the 3–4 ports of conventional VATS, reducing postoperative pain and recovery time. Shanghai Pulmonary Hospital has performed over 75,000 single-port VATS procedures — the most of any hospital in the world — trained surgeons from more than 76 countries, and achieves a 96.3% minimally invasive rate for lung resections. Chinese surgeons pioneered the subxiphoid uniportal VATS approach in 2014 — a single incision below the breastbone rather than between the ribs, eliminating intercostal nerve injury — now adopted by major thoracic centers worldwide.

References [R1-R4]

CTEPH treatment at Fuwai — Asia's most complete program, all under one roof.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition where organized blood clots permanently obstruct the pulmonary arteries and progressively destroy the right heart. Fuwai Hospital, China's national cardiovascular center, offers the full spectrum of CTEPH treatment under one roof: for operable patients, pulmonary endarterectomy (PEA) — the only curative surgery — with a 5-year survival of 91.2% and perioperative mortality reduced to 1.2% in the modern era; for inoperable patients, one of Asia's largest balloon pulmonary angioplasty (BPA) programs with a refined multi-session protocol; and for patients with contrast allergy or renal dysfunction, Chinese investigators at Fuwai Yunnan Hospital pioneered CT fusion-guided zero-contrast BPA in 2024 — the first reported technique of its kind globally. Few centers anywhere offer PEA, BPA, and zero-contrast BPA as a single integrated pathway.

References [R7a][R7b][R8]

Tubeless VATS — lung surgery without a breathing tube.

Tubeless VATS is indicated for early-stage lung cancer, peripheral lung lesions, pulmonary bullae, spontaneous pneumothorax, and selected mediastinal tumors — particularly where avoiding mechanical ventilation is advantageous (mild lung-function impairment, elderly, or asthma). Standard thoracic surgery uses a breathing tube and a chest drain, both of which can prolong recovery and cause complications. Professor He Jianxing's team at the First Affiliated Hospital of Guangzhou Medical University pioneered “tubeless VATS” — surgery performed with the patient breathing spontaneously under regional anesthesia plus sedation, no intubation, and no chest drain afterward. The technique reduces anesthesia exposure, eliminates ventilator-associated lung injury, and shortens time to ambulation. China has held international training courses on this technique since 2015, attracting thoracic surgeons from multiple countries.

References [R5-R6]

Esophageal cancer multidisciplinary treatment — the world's highest surgical experience.

Esophageal cancer treatment is indicated for squamous cell carcinoma and adenocarcinoma of the esophagus and gastroesophageal junction across early to locally advanced stages, and requires coordinated multimodal management: neoadjuvant chemotherapy or chemoradiotherapy, immunotherapy in selected patients, minimally invasive thoracoscopic-laparoscopic esophagectomy (Ivor Lewis, McKeown, or Sweet approaches), and integrated nutritional and rehabilitation support. China carries approximately half of the global esophageal cancer burden — with the world's highest case volume and surgical experience. Leading centers include the National Cancer Center (CAMS, Beijing), Zhongshan Hospital (Fudan), Shanghai Chest Hospital, and Sichuan Cancer Hospital, together performing thousands of esophagectomies per year. Chinese surgical groups have published large-scale outcomes including the CMISG1701 randomized trial comparing minimally invasive versus open esophagectomy. The combination of disease prevalence, standardized surgical pathways, and ESCC-specific clinical trials makes China a uniquely deep destination for esophageal cancer care.

Neoadjuvant immunotherapy before surgery — China's scale advantage.

Neoadjuvant immunotherapy is indicated for resectable stage II–IIIA (and selected IIIB) non-small cell lung cancer, where preoperative immunotherapy plus chemotherapy can downstage the tumor and improve the chance of complete (R0) resection. The strategy can shrink tumors, improve complete-removal rates, and eliminate microscopic spread before it takes hold. China has by far the largest real-world experience with this approach globally. The NeoR-World study — the largest real-world cohort of its kind — enrolled 408 patients across 11 Chinese centers and found a pathologic complete response rate of 32.4% with immunotherapy plus chemotherapy versus 6.4% with chemotherapy alone, and a 2-year overall survival of 93.1%. China's surgical volume means patients can access neoadjuvant immunotherapy followed by high-volume expert resection within the same integrated thoracic-oncology pathway.

References [R17]

Microwave ablation for lung tumors — destroying tumors with heat, no incision.

Microwave ablation (MWA) is indicated for early-stage non-small cell lung cancer in patients who cannot tolerate surgery, oligometastatic lung disease, and recurrent lung tumors after prior radiotherapy or surgery. It is an image-guided, percutaneous, minimally invasive treatment in which a microwave antenna heats and destroys tumor tissue from within. The technology was developed internationally; China has built one of the world's strongest bodies of clinical evidence for MWA in lung tumors — led by Prof. Xin Ye and the Shandong Lung Cancer Institute, with the first Chinese Expert Consensus on thermal ablation of primary and metastatic lung tumors (2015), multi-center phase III trials, and ongoing studies combining MWA with immunotherapy. MWA can complete a lung-tumor treatment in roughly 30 minutes with same- or next-day discharge — at substantially lower cost than surgical resection.

References [R20-R21]

SHURUI single-port surgical robot — China-developed, globally certified.

Developed by Beijing Surgerii Robotics on core technology from Shanghai Jiao Tong University, the SHURUI single-port surgical robot is the world's first commercially available surgical robot with snake-like flexible instruments using a dual-continuum mechanism — enabling complex lung resections through a single small incision. NMPA-approved in China in 2023 for thoracic surgery and CE-certified in Europe in 2025, SHURUI is the world's second approved single-port surgical robot overall and the first Chinese-developed system of its kind. Phase 1/2 trial data confirmed safety and feasibility for lobectomy and segmentectomy in lung cancer, with no conversions to open surgery and a median blood loss of 10 mL.

References [R18-R19]

AI lung-nodule diagnosis — China's national clinical standard.

China is the first country to formally integrate AI imaging systems for pulmonary-nodule detection into a national clinical standard. The 2024 Chinese Expert Consensus mandates human-machine multidisciplinary team (MDT) assessment — AI-flagged nodules are reviewed alongside radiologist judgement, not as a replacement — setting a benchmark ahead of any other national health system.

Robotic bronchoscopy — the domestic UniPath platform (MicroPort MedBot).

China has developed its own robotic bronchoscopy platform — the UniPath system by MicroPort MedBot, co-developed with Shanghai Chest Hospital and West China Hospital and approved by the NMPA in December 2025. It enables guided biopsy of small peripheral nodules deep in the lung that are too small or too peripheral for conventional bronchoscopy and too risky for CT-guided biopsy. MicroPort MedBot is the first company globally to commercialize a full suite of surgical robots across five surgical specialties.

AI pathology for lung cancer — built on the world's largest patient population.

AI pathology for lung cancer supports AI-assisted histology classification, tumor grading, and molecular biomarker prediction (EGFR, ALK, PD-L1) directly from H&E-stained pathology slides. China has built a robust AI digital-pathology ecosystem for lung cancer, leveraging the world's largest lung-cancer patient population to train its models. Multiple Chinese hospitals (Shanghai Pulmonary, National Cancer Center / CAMS, Tongji) have published AI-pathology validation studies for lung-cancer subtyping (adenocarcinoma vs squamous), micropapillary-pattern detection, and biomarker prediction. Several Chinese AI pathology platforms have received NMPA Class II approval and are deployed at major thoracic oncology centers. For international patients, this can support faster, more comprehensive pathology review alongside human pathologist assessment.

400-gene NGS — standard access at China's leading lung-cancer centers.

Comprehensive next-generation sequencing covering 400+ genes is standard practice at China's leading lung-cancer centers. This broad panel identifies rare driver mutations, fusion events, and resistance mechanisms — matching each patient to the most appropriate therapy within China's extensive precision-drug portfolio. For patients with uncommon mutations such as MET exon 14, EGFR exon 20 insertion, or rare fusions, this comprehensive testing is what opens access to the China-only drugs described above.