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About 4.8 million new cancer cases in 2022 and 2.6 million cancer deaths in 2022; 17,535 oncology papers in 2025 (up 52% since 2021) and 54,606 registered trials with a Chinese site. In one decade China went from importing every new cancer drug to approving its own PD-1 antibodies, ADCs, bispecifics, CAR-Ts and KRAS inhibitors and licensing them to Western pharma. This page pairs each problem with what is being done about it, and links every number to its source.
The National Cancer Center's 2024 report: lung, colorectal, thyroid, liver and stomach cancers made up 57.42% of new cases; from 2000 to 2018 incidence rose about 1.4% a year while mortality fell about 1.3% a year; oesophageal, stomach and liver cancer rates are falling, thyroid, prostate and cervical rates rising. Figures are estimates projected from 106 continuous registries (2010 to 2018) among the 700 registries reporting to the National Central Cancer Registry. GLOBOCAN 2022 gives an age-standardised incidence of 202 and mortality of 129 per 100,000 for China on a different population standard (IARC fact sheet).
Digestive cancers dominate. Stomach, liver and oesophageal cancer sit in the top five by deaths, driven by chronic hepatitis B, Helicobacter pylori, salted and pickled food, hot beverages and alcohol, and concentrated in rural high-incidence belts (Taihang mountains, Huai river basin, Qidong). Most are diagnosed late, where five-year survival is low.
Universal newborn hepatitis B vaccination since 1992 (free since 2005) is already cutting liver cancer: the Qidong cluster-randomised trial showed in Qidong, Jiangsu, 39,292 newborns vaccinated between 1985 and 1990 (34,441 unvaccinated controls) had 84% (95% CI 23 to 97%) protection against HBV-related primary liver cancer before age 30 and 72% lower HBsAg carriage by young adulthood. The National Cancer Center runs endoscopic screening for oesophageal and stomach cancer in high-incidence rural counties and liver ultrasound plus AFP screening in HBV carriers. Chemo-immunotherapy from five Chinese PD-1 trials (JUPITER-06, ESCORT-1st, RATIONALE-306, ORIENT-16, CARES-310) is now first-line standard in oesophageal, gastric and liver cancer, and the first Claudin 18.2 CAR-T (Satricabtagene autoleucel) was approved for gastric cancer in 2025.
Survival lags rich countries. Age-standardised five-year relative survival for all cancers was 30.9% in 2003 to 2005 and remains well below the roughly two-thirds seen in the US, Japan and Western Europe, with wide urban-rural and east-west gaps in stage at diagnosis and access to specialist care.
The Healthy China 2030 outline (2016) set a national target to raise the overall cancer five-year survival rate by 15 percentage points by 2030 and lift life expectancy to 79.0 years; the Healthy China Action (2019) made cancer one of fifteen special actions with screening, early diagnosis and standardised treatment goals. Survival has improved from 30.9% in 2003 to 2005 to 43.7% in 2019 to 2021. National quality-control centres, tumour boards and CSCO and CACA guidelines aim to standardise treatment across provinces.
Paying for innovation. Until 2017 most new targeted drugs and all PD-1 antibodies were self-pay, out of reach for the majority; catastrophic spending on cancer drugs was common, and a listed drug could still be unavailable if hospitals declined to stock it because of budget caps.
The National Healthcare Security Administration (National Healthcare Security Administration) now negotiates the National Reimbursement Drug List every year: the 2017 negotiation listed 15 targeted anticancer medicines and cut the cost per defined daily dose by 48.9% on average; the dedicated 2018 oncology round added 17 innovative anticancer medicines to the list; since 2019 dozens of oncology drugs join each round at discounts usually above half, and for metastatic lung cancer drugs the largest price fall comes at NRDL negotiation (median 54.8% reduction). Renewal rules cap further cuts for drugs already listed (of 104 anticancer drugs negotiated between 2017 and 2023, 68 went through renewal negotiations), a dual-channel policy (2021) lets designated pharmacies dispense listed drugs when hospitals do not, and provincial supplementary insurance (huiminbao) covers some drugs still off the list. The trade-off: prices so low that some Western drugs are not launched in China, and cell therapies (list prices above CN¥ 1 million) remain unlisted.
China-only evidence travels badly. Registration trials run entirely in China with chemotherapy comparators (sintilimab's ORIENT-11) were rejected by the FDA in 2022, and camrelizumab plus rivoceranib has drawn three complete response letters over inspections and trial conduct, so Chinese PD-1s reached Western patients years late or not at all.
The NMPA and CDE reforms since 2015 (backlog cleared, ICH membership 2017, acceptance of overseas data, breakthrough and conditional pathways) made Chinese trials faster; companies now run multiregional confirmatory studies (RATIONALE-302 for tislelizumab, HARMONi-3 for ivonescimab, ASTRIDE for serplulimab, FRESCO-2 for fruquintinib) and license Western rights to partners who run them. Tislelizumab, toripalimab, penpulimab, fruquintinib, zanubrutinib, ensartinib and ciltacabtagene autoleucel now hold FDA approvals.
Quantity over differentiation. More than a dozen PD-1 and PD-L1 antibodies are approved in China, many for the same indications, and the resulting price war has left most of them unprofitable; me-too kinase inhibitors crowd the EGFR, ALK and BTK classes.
The next wave is differentiated: PD-1 x VEGF and PD-1 x CTLA-4 bispecifics (Ivonescimab, Cadonilimab), topoisomerase-payload ADCs (Sacituzumab tirumotecan, Trastuzumab rezetecan, Izalontamab brengitecan), fully human BCMA CAR-Ts and solid-tumour CAR-Ts, and BTK degraders. Western pharma is buying it: the deals below total tens of billions of dollars in headline value, most signed since 2023.
Nasopharyngeal carcinoma is endemic in Guangdong, Guangxi and Hong Kong, tied to Epstein-Barr virus, and until 2018 had no approved immunotherapy anywhere.
Sun Yat-sen University Cancer Center trials under Jun Ma and colleagues set induction chemotherapy and EBV DNA-guided treatment; JUPITER-02 made toripalimab the first PD-1 antibody approved for nasopharyngeal cancer in China (2021) and the US (2023), with penpulimab following in 2025. Plasma EBV DNA screening of 20,174 asymptomatic men in Hong Kong found 34 nasopharyngeal cancers, 71% at stage I or II versus 20% in an unscreened historical cohort, pointing to a screening route for endemic regions.
China's drug regulator and its review centre, whose reforms since 2015 turned China into the world's second-largest source of new cancer drugs and a leader in ADCs and bispecifics.
The NHSA runs China's public health insurance and negotiates once a year which new cancer drugs are reimbursed, and at what price, through the National Reimbursement Drug List.
The National Cancer Center is the body that counts China's cancers, sets national screening and quality programmes and publishes the country's official cancer statistics.
China's clinical oncology society, whose annual meeting and disease guidelines are the reference for treatment in the world's largest cancer patient population.
The China Anti-Cancer Association is the country's largest cancer society, publishing the CACA guidelines that aim to reflect Chinese patients and Chinese drugs rather than imported recommendations.
CTONG is the cooperative group of Chinese lung cancer trialists, founded by Yi-Long Wu, whose trials on EGFR-targeted pills before and after surgery changed practice worldwide.
Domestic innovative products and the imports China approved, grouped by modality. Each product page lists the indication and year; the regional approvals table has 211 products with an NMPA approval or conditional approval on record.
Registration trials of Chinese drugs, newest first. The ORIENT, RATIONALE, CameL, JUPITER, HARMONi, CAPSTONE and GEMSTONE programmes reproduced the Western PD-(L)1 results in Chinese populations; LEGEND-2 is where Carvykti began; FURLONG and AENEAS are the head-to-head EGFR trials.
| Trial | Setting | Result | |||
|---|---|---|---|---|---|
| A Study Investigating the Efficacy and Safety of Alcestobart (LBL-007) Plus Tislelizumab in Combination With Bevacizumab Plus Fluoropyrimidine Versus | Phase 1/2 | Active | A Phase 1b/2, Randomized, Open-Label Study Investigating the Efficacy and Safety of LBL-007 Plus Tislelizumab in Combination With Bevacizumab Plus Fluoropyrimidine Versus Bevacizumab Plus Fluoropyrimidine as Maintenance Therapy in Patients With Unresectable or Metastatic Microsatellite Stable/Mismatch Repair Proficient Colorectal Cancer | A phase 1/2 trial of Tislelizumab in colorectal cancer, run by BeiGene, active and no longer recruiting. | 2026 |
| A Study of Nofazinlimab (CS1003) in Subjects With Advanced Hepatocellular Carcinoma | Phase 3 | Active | A Multi-Center, Double-Blind, Randomized, Phase III Study to Investigate the Efficacy and Safety of Nofazinlimab (CS1003) in Combination With Lenvatinib Compared to Placebo in Combination With Lenvatinib as First-Line Therapy in Subjects With Advanced Hepatocellular Carcinoma (HCC) | A phase 3 trial of Lenvatinib in hepatocellular carcinoma, run by CStone Pharmaceuticals, active and no longer recruiting. | 2026 |
| Comparing the Efficacy and Safety of a New Additional Treatment With Tislelizumab in Non-Small Cell Lung Cancer (NSCLC) | Phase 3 | Active | A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study to Compare the Efficacy and Safety of Neoadjuvant Treatment With Tislelizumab (BGB-A317, Anti-PD-1 Antibody) or Placebo Plus Platinum-Based Doublet Chemotherapy Followed By Adjuvant Tislelizumab or Placebo in Resectable Stage II or IIIA Non-Small Cell Lung Cancer | At the final analysis (median follow-up 38.5 months) overall survival favoured perioperative tislelizumab (hazard ratio 0.65, 95 percent confidence interval 0.45 to 0.93, p=0.009); 36-month overall survival 79.3 against 69.3 percent. | 2026 |
| HERIZON-GEA-01 | Phase 3 | Positive | First-line HER2-positive advanced gastro-oesophageal adenocarcinoma: zanidatamab + chemotherapy ± tislelizumab vs trastuzumab + chemotherapy | PFS 12.4 vs 8.1 months (HR 0.63-0.65); OS significantly improved. | 2026 |
| Osimertinib Plus Savolitinib in EGFRm+/MET+ NSCLC Following Prior Osimertinib | Phase 2 | Active | A Phase II Study Assessing the Efficacy of Osimertinib in Combination With Savolitinib in Patients With EGFRm+ and MET+, Locally Advanced or Metastatic Non Small Cell Lung Cancer Who Have Progressed Following Treatment With Osimertinib. | A phase 2 trial of Osimertinib and Savolitinib in advanced solid tumours, run by AstraZeneca, active and no longer recruiting. | 2026 |
| Study of BGB-11417 Monotherapy in Participants With Relapsed or Refractory Mantle Cell Lymphoma | Phase 1/2 | Active | A Single-Arm, Open-Label, Multicenter Phase 1/2 Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of BCL2 Inhibitor BGB-11417 in Patients With Relapsed or Refractory Mantle Cell Lymphoma | A phase 1/2 trial of Sonrotoclax in mantle cell lymphoma, run by BeiGene, active and no longer recruiting. | 2026 |
| Study of Pimicotinib (ABSK021) for Tenosynovial Giant Cell Tumor (MANEUVER) | Phase 3 | Active | A Phase 3, Randomized, Double-blind, Placebo-Controlled, Multicenter Study of ABSK021 to Assess the Efficacy and Safety in Patients With Tenosynovial Giant Cell Tumor | A phase 3 trial of Pimicotinib(ABSK021) in tenosynovial giant cell tumour, run by Abbisko Therapeutics Co, Ltd, active and no longer recruiting. | 2026 |
| Assessing an Oral EGFR Inhibitor, Sunvozertinib in Patients Who Have Advanced Non-small Cell Lung Cancer With EGFR or HER2 Mutation (WU-KONG1) | Phase 1/2 | Active | A Phase I/II, Open-Label, Multicenter Study to Assess the Safety, Tolerability, Pharmacokinetics and Anti-tumor Efficacy of DZD9008 in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) With EGFR or HER2 Mutation | A phase 1/2 trial of Sunvozertinib in non-small-cell lung cancer and small-cell lung cancer, run by Dizal Pharmaceuticals, active and no longer recruiting. | 2025 |
| CT041-ST-01 | Phase 1/2 | Positive | CLDN18.2-positive advanced gastric or gastro-oesophageal junction adenocarcinoma after at least two prior lines, China: satricabtagene autoleucel versus treatment of physician's choice | Median progression-free survival 3.25 vs 1.77 months (hazard ratio 0.37) in 156 randomised patients. | 2025 |
| HORIZON-Breast01 | Phase 3 | Positive | HER2+ metastatic breast cancer after trastuzumab and taxane (China): trastuzumab rezetecan (SHR-A1811) vs pyrotinib + capecitabine | PFS 30.6 vs 8.3 months, HR 0.22. | 2025 |
| Study to Compare the Efficacy and Safety of F-627 and GRAN® | Phase 3 | Completed | A Phase III, Multi-Center, Randomized, Open-Label, Active-Controlled Study to Compare the Efficacy and Safety of F-627 and GRAN® in the Prophylactic Treatment for Chemotherapy-Induced Neutropenia | A phase 3 trial of Efbemalenograstim alfa and Filgrastim in Breast cancer, run by EVIVE Biotechnology, completed. | 2025 |
| COMPASSION-16 / AK104-303 | Phase 3 | Positive | Persistent, recurrent, or metastatic cervical cancer, first line (China): cadonilimab (PD-1×CTLA-4 bispecific) + platinum-paclitaxel ± bevacizumab vs placebo + chemotherapy ± bevacizumab | OS HR 0.64; PFS HR 0.62. | 2024 |
| CONTINUUM | Phase 3 | Positive | High-risk locoregionally advanced nasopharyngeal carcinoma (stage III to IVa, excluding T3-4N0 and T3N1) in adults aged 18 to 65 at nine Chinese hospitals: gemcitabine-cisplatin induction and concurrent cisplatin radiotherapy with or without 12 cycles of the PD-1 antibody sintilimab, with event-free survival as the primary endpoint | Three-year event-free survival 86 percent with sintilimab added to chemoradiotherapy against 76 percent without (hazard ratio 0.59, p 0.019); grade 3 to 4 adverse events 74 against 65 percent. | 2024 |
| FUMANBA-1 | Phase 1/2 | Positive | Relapsed or refractory multiple myeloma after three or more lines, China: single-arm study of equecabtagene autoleucel | ORR about 96% in infused patients (JAMA Oncol 2024). | 2024 |
| HARMONi-2 | Phase 3 | Positive | First-line PD-L1-positive (TPS ≥1%) advanced NSCLC in China: ivonescimab vs pembrolizumab monotherapy | PFS HR 0.51; OS statistically significant (2026 announcement). | 2024 |
| HARMONi-A | Phase 3 | Positive | EGFR-mutant non-squamous NSCLC after progression on an EGFR TKI, China: ivonescimab or placebo plus pemetrexed and carboplatin | PFS 7.1 vs 4.8 months, HR 0.46. | 2024 |
| LUMMICAR STUDY 1 | Phase 1/2 | Positive | Relapsed or refractory multiple myeloma after three or more lines, China: single-arm study of zevorcabtagene autoleucel (CT053) | The Chinese trial behind zevor-cel's approval for multiple myeloma, showing deep and lasting responses with a fully human BCMA CAR-T. | 2024 |
| Neotorch | Phase 3 | Positive | Resectable stage II or III non-small-cell lung cancer in China, without EGFR or ALK alterations for non-squamous disease: toripalimab 240 mg or placebo every three weeks with platinum chemotherapy for three cycles before surgery and one after, then toripalimab or placebo alone for up to 13 cycles, with dual primary endpoints of event-free survival and major pathological response | Median event-free survival not estimable against 15.1 months in stage III disease (hazard ratio 0.40, 95 percent confidence interval 0.28 to 0.57). | 2024 |
| CARES-310 | Phase 3 | Positive | First-line unresectable HCC: camrelizumab + rivoceranib vs sorafenib | OS 23.8 vs 15.2 months, HR 0.62. | 2023 |
| CARTITUDE-4 | Phase 3 | Positive | Lenalidomide-refractory myeloma after 1-3 prior lines: cilta-cel vs Pom-Vd or Dara-Pd | PFS HR 0.26; OS HR 0.55. | 2023 |
| FRESCO-2 | Phase 3 | Positive | Refractory metastatic colorectal cancer after all standard therapies: fruquintinib vs placebo | OS 7.4 vs 4.8 months, HR 0.66. | 2023 |
| HERIZON-BTC-01 | Phase 2 | Positive | HER2-amplified unresectable, locally advanced or metastatic biliary tract cancer after gemcitabine-based therapy: zanidatamab 20 mg/kg every 2 weeks, single arm; cohort 1 IHC 2+ or 3+ (n=80), cohort 2 IHC 0 or 1+ (n=7) | Confirmed ORR by independent central review 41.3% (33/80, 95% CI 30.4 to 52.8) in HER2 IHC 2+/3+ cohort; grade 3 treatment-related adverse events 18%; 53% of patients had gallbladder cancer. | 2023 |
| ORIENT-16 | Phase 3 | Positive | First-line unresectable gastric or gastro-oesophageal junction adenocarcinoma, China: sintilimab or placebo plus oxaliplatin and capecitabine | OS 15.2 vs 12.3 months (HR 0.77); CPS ≥5: 18.4 vs 12.9 months (HR 0.66). | 2023 |
| ROSEWOOD | Phase 2 | Positive | Relapsed or refractory follicular lymphoma after two or more lines including an anti-CD20 antibody and an alkylating agent: zanubrutinib with obinutuzumab against obinutuzumab alone | Overall response 69 against 46 per cent (p = 0.001) and median progression-free survival 28.0 against 10.4 months (hazard ratio 0.50). | 2023 |
| AENEAS | Phase 3 | Positive | First-line EGFR-mutant (exon 19 deletion or L858R) locally advanced or metastatic NSCLC, China: aumolertinib vs gefitinib | PFS 19.3 vs 9.9 months, HR 0.46. | 2022 |
| ALPINE | Phase 3 | Positive | Relapsed or refractory CLL/SLL: zanubrutinib vs ibrutinib | PFS HR 0.65; AF 5.2% vs 13.3%. | 2022 |
| ASTRUM-005 | Phase 3 | Positive | First-line ES-SCLC: serplulimab + carboplatin-etoposide vs placebo + carboplatin-etoposide | OS 15.4 vs 10.9 months, HR 0.63. | 2022 |
| CAPSTONE-1 | Phase 3 | Positive | First-line extensive-stage small cell lung cancer, China: adebrelimab or placebo plus carboplatin and etoposide | OS 15.3 vs 12.8 months, HR 0.72. | 2022 |
| FURLONG | Phase 3 | Positive | First-line EGFR-mutant (exon 19 deletion or L858R) locally advanced or metastatic NSCLC, China: furmonertinib vs gefitinib | PFS 20.8 vs 11.1 months, HR 0.44. | 2022 |
| GEMSTONE-301 | Phase 3 | Positive | Locally advanced unresectable stage III non-small-cell lung cancer in China without progression after either concurrent or sequential chemoradiotherapy: sugemalimab 1200 mg or placebo every three weeks for up to 24 months, with progression-free survival by blinded independent central review as the primary endpoint | Median progression-free survival 9.0 against 5.8 months by blinded independent review, including after sequential chemoradiotherapy. | 2022 |
Terms as announced by the parties: upfront is cash at signing, total is the headline figure including milestones. Where a number is not public the cell is empty.