Southwest: The driver gene-negative NSCLC market has broad space, with both dual (or multiple) antibody and IO+ADC schemes advancing side by side.

Southwest released a research report stating that the current first-line treatment for driver gene negative advanced NSCLC patients mainly relies on the treatment regimen of PD(L)-1chemotherapy. It is estimated that by 2030, the market size of immune drugs used for first-line treatment of driver gene negative advanced NSCLC in the US will be approximately 7.5 billion and 18 billion respectively. The next generation of immune therapy options for NSCLC includes dual or multiple antibodies and IO+ADC. For dual or multiple antibody therapy, future catalysts to watch for include the key clinical data readouts for in 2026, the initiation of the multi-phase III clinical trial for SSGJ-707, and the clinical exploration and data readouts for dual antibody+ADC. As for IO+ADC therapy, it is recommended to pay attention to the key data readouts for 26H1 AVANZAR and 26H2 SKB264--14. Southwest's main points are as follows: What is the status of driver gene negative space? Driver gene negative refers to the absence of clearly targetable driver gene mutations in tumor samples, accounting for 31% in both new NSCLC patients in China and the US. Based on current guidelines in China and the US, the first-line treatment for driver gene negative advanced NSCLC patients mainly relies on the treatment regimen of PD(L)-1chemotherapy. It is estimated that by 2030, the market size of immune drugs used for first-line treatment of driver gene negative advanced NSCLC in the US will be approximately 7.5 billion and 18 billion respectively. Next-generation immune therapy options for NSCLC are advancing concurrently - dual or multiple antibodies, IO+ADC. From the clinical guidelines, PD(L)-1 drugs represented by pembrolizumab and atezolizumab (not) combined with chemotherapy have comprehensively covered the first-line and second-line treatment for driver gene negative NSCLC, maintaining a stable clinical status. However, in the long term, there are limitations: 1) Immunotherapy resistance, long-term efficacy reaching a plateau period (dual antibody): Compared to traditional chemotherapy, immunotherapy with or without chemotherapy can significantly improve long-term survival rates, but the 5-year survival rate decreases to 10%-30%, and long-term treatment effects for PD-L1 medium-low expressors gradually reach a bottleneck. 2) Limited options for chemotherapy intolerant patients, scarce strong regimens. Currently, evidence only supports the use of immune monotherapy (such as atezolizumab or pembrolizumab) for patients with high PD-L1 expression (TPS 50%), while patients with medium-low expression and those intolerant to chemotherapy lack clinically effective options (IO+ADC). Dual or multiple antibody therapy: Dual-specificity antibodies can bind to two antigens or antigen epitopes simultaneously, achieving a balance between safety and efficacy. The approval and commercialization of pembrolizumab in 2024 sparked a PD-(L)1/VEGF frenzy, with over 10 companies entering the field, resulting in large-scale BD and record-breaking transaction amounts. PD-(L)1/CLTA-4 has the triple advantages of mechanism synergy, safety optimization, and coverage of more tumor types. With the validation of dual antibody clinical data and technical pathways, triple antibodies are expected to become a new focus of IO therapy. Future catalysts to watch for include the key clinical data readouts for in 2026, the initiation of the multi-phase III clinical trial for SSGJ-707, and the clinical exploration and data readouts for dual antibody+ADC. Related targets: AKESO, 3SBIO/Sunshine Guojian Pharmaceutical, PuMiSi, REMEGEN, Zhejiang Huahai Pharmaceutical. IO+ADC therapy: ADC links cytotoxic drugs to monoclonal antibodies targeting tumors, combining the characteristics of targeted drugs and chemotherapy to achieve precise dosing and low-toxicity and efficient treatment. The clinical results of TROP2 ADC+K drugs are non-inferior to K drug+ chemotherapy in terms of ORR and PFS data, with squamous cell carcinoma showing excellent performance, providing new solutions for patients intolerant to chemotherapy. Future catalysts to watch for include the key data readouts for 26H1 AVANZAR and 26H2 SKB264--14. Related targets: Kelun Biotech, Jiangsu Hengrui Pharmaceuticals. Risk warnings: Risks include delays in research and development progress, worsening competitive landscape, lower-than-expected market promotion, and policy risks.