Pfizer/Zai Lab’s Tivdak wins first China market nod for cervical cancer

China’s NMPA issued an approval for Tivdak (tisotumab vedotin) as a treatment for recurrent or metastatic cervical cancer, making it the first antibody-drug conjugate cleared for this indication in China. Zai Lab Limited (Nasdaq: ZLAB; HKEX: 9688) holds exclusive rights to the drug across Greater China under a license originally executed with Seagen — subsequently acquired by Pfizer — and will be responsible for its commercialization. With an estimated 150,000 new cervical cancer diagnoses annually in China, the approval addresses a population where treatment options after platinum-based chemotherapy remain limited.

The NMPA approved Tivdak for adult patients with recurrent or metastatic cervical cancer whose disease has progressed on or after chemotherapy, administered intravenously. Tisotumab vedotin is an ADC comprising a human monoclonal antibody directed against tissue factor (TF), developed by Genmab, conjugated via a protease-cleavable linker to monomethyl auristatin E (MMAE), using Pfizer’s ADC platform technology. Upon binding to TF-expressing tumor cells, the ADC-TF complex is internalized and MMAE is released, disrupting microtubule polymerization and triggering cell cycle arrest and apoptosis.

The approval is supported by the global, randomized Phase III innovaTV 301 trial (NCT04697628), which enrolled adults with previously treated recurrent or metastatic cervical cancer. The trial met its primary endpoint of overall survival (OS) in the intention-to-treat population, with a hazard ratio of 0.70 (95% CI: 0.54–0.89; p=0.0038) versus investigator’s choice chemotherapy. A prespecified China subpopulation analysis, presented at the 2025 Chinese Society of Clinical Oncology meeting, showed an HR of 0.55 (95% CI: 0.27–1.15), corresponding to a reported 45% reduction in the risk of death. Notably, 54.1% of the China subpopulation had received prior anti-PD-(L)1 therapy, and OS benefit trends remained consistent regardless of prior immunotherapy exposure.

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TF is broadly expressed across multiple solid tumor types, and its role as an ADC target has attracted wider interest. CSPC Pharmaceutical has advanced a TF-targeting ADC into Phase I development for advanced solid tumors, citing Tivdak’s clinical validation of the antigen. The NMPA approval extends a regulatory sequence that includes clearances in the US, EU, Japan, UK, Hong Kong, and Macau, and positions Tivdak as the reference ADC in this indication globally.

In the competitive landscape, Tivdak is currently the only approved ADC for recurrent or metastatic cervical cancer and has been designated as the comparator arm in at least one registrational trial for a competing agent: Corbus Pharmaceuticals has aligned with the FDA on a Phase III design for a CSPC-licensed Nectin-4 ADC that uses tisotumab vedotin as the control. Nectin-4-targeting ADCs represent the most active competing modality in this space, with Jiangsu Hengrui’s Nectin-4 ADC having received China breakthrough designation from the same NMPA that approved Tivdak, signaling a likely near-term challenge to its first-mover position in China.


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