Dual-Target Anti-VEGF Race Heats Up with RemeGen-Santen $180M Deal
RemeGen’s $180M deal with Santen for RC28-E, a VEGF/FGF dual-target drug, highlights the growing anti-VEGF race in China’s eye drug market, where dual-target therapies and biosimilars, including Vabysmo and Conbercept, are reshaping wAMD and DME treatment.
On August 19, 2025, RemeGen licensed its VEGF/FGF bispecific RC28-E to Santen Pharma for exclusive rights in Greater China and seven Asian markets, in a deal worth up to RMB 1.295B (~USD 180M) (RMB 250M upfront, milestones, and royalties). RemeGen keeps global rights, underscoring its ambitions beyond Asia.
The asset is in Phase 3 for wet AMD and DME, following ARVO 2025 Phase 2 data (+8–10 BCVA letters). With China’s ~3.8M wAMD and 5.7M DME patients, Santen’s ophthalmology network should accelerate commercialization.
The partnership strengthens competition in the crowded anti-VEGF arena, where bispecifics like Roche’s Vabysmo are reshaping treatment and Chinese players push toward global relevance.
Anti-VEGF Market: Size and Drivers
The global anti-VEGF ophthalmic market hit ~USD 13B in 2024, projected to surpass USD 22B by 2030 (6.1% CAGR). China’s market reached ~USD 2.1B in 2024, projected to ~USD 3.9B by 2030 (GVR), with anti-VEGF as the largest class.
Key Growth Drivers:
· Demographic Surge: ~288M global AMD cases by 2040; China’s 140M diabetics fuel nAMD/DME growth.
- Unmet Needs: Resistance and fibrosis in single-target therapies drive demand for dual/multi-target drugs with extended dosing.
- Biosimilar Wave: Patent cliffs for Eylea and Lucentis boost affordability but challenge innovators.
Established Players and Blockbusters
The market pits global and Chinese leaders against emerging innovators:
|
Drug |
Developer |
Mechanism |
Indications |
2024 Sales (USD) |
Notes |
|
Eylea (aflibercept) |
Regeneron/Bayer |
VEGF-A/B & PlGF trap |
nAMD, DME, RVO |
~6 B(U.S.) |
~35% share; biosimilars eroding (2023: 9.2B). |
|
Vabysmo (faricimab) |
Roche/Genentech |
VEGF-A/Ang-2 bispecific |
nAMD, DME, RVO |
~4.2B |
68% CAGR since 2022; quarterly dosing gains traction. |
|
Lucentis (ranibizumab) |
Novartis/Roche |
VEGF-A inhibitor |
nAMD, DME, RVO |
~1.5-2B (U.S.) |
First anti-VEGF (2006); generics hit sales. |
|
Conbercept (Langmu) |
Kanghong Pharmaceutical |
VEGF-A/B & PlGF fusion |
nAMD, DME |
~0.18B (est.) |
China’s top eye drug; 21% YoY growth. |
|
Beovu (brolucizumab) |
Novartis |
VEGF-A inhibitor |
nAMD |
~0.5B |
Limited by safety concerns. |
- Global Leaders: Eylea dominates, but Vabysmo’s rapid rise could overtake it by 2027. Lucentis and Beovu face biosimilar pressure, while off-label Avastin persists for cost savings.
- Chinese Stars: Kanghong’s Conbercept holds >50% domestic share. Qilu’s biosimilars (bevacizumab 2019, aflibercept 2023, ranibizumab 2024) drive affordability. Innovent, Hengrui, and OcuMension advance next-gen candidates.
Dual-Target Products and Candidates: A High-Value Innovation
Dual-target therapies are revolutionizing ophthalmology by addressing fibrosis and reducing injection frequency. Only Roche’s Vabysmo is marketed, but China and Western pharmas are advancing robust pipelines. Below is a ranked overview (Marketed > NDA > Phase 3 > Phase 2 > Phase 1 > Preclinical) of key drugs for nAMD, DME, and RVO, as of August 19, 2025.
|
Drug Name |
Company |
Target Pathways |
Clinical Stage |
Results |
Notes |
|
Vabysmo (faricimab) |
Roche/Genentech (Switzerland/US) |
VEGF-A/Ang-2 |
Marketed (FDA 2022) |
Phase 3 (TENAYA/LUCERNE, YOSEMITE/RHINE): Non-inferior
BCVA gains vs. aflibercept (+5.8-6.6 letters); CST reductions (~140-200 μm);
up to 16-week dosing. |
First bispecific for eyes; reduces injections; ~USD 4.4B
sales in 2024. |
|
IBI302 |
Innovent Biologics (China) |
VEGF/Complement (C3b/C4b) |
Phase 3 |
Phase 2 (ARVO 2025): BCVA gains (~7-9 letters) and CST
reductions (~130 μm) vs. aflibercept in nAMD; fewer injections; ~40% macular
atrophy reduction. |
First-in-class VEGF/complement bispecific; targets
inflammation; global potential; Phase 3 STAR trial ongoing for nAMD/DME. |
|
RC28-E |
RemeGen (China) |
VEGF/FGF |
Phase 3 |
Phase 2 (ARVO 2025): DME BCVA +8-10 letters; Phase 1b
nAMD: BCVA gains in refractory patients. |
Unique anti-fibrosis mechanism; BLA planned for DME (H2
2025), nAMD (mid-2026); Santen licensing deal (Aug 2025). |
|
KSI-501 |
Kodiak Sciences (US) |
VEGF/IL-6 |
Phase 3 |
Phase 1 (2023-2025): Safe, biologic activity in DME; no
dose-limiting toxicities. |
Bispecific conjugate; targets inflammation for DME/nAMD;
Phase 3 DAYBREAK in wAMD actively enrolling, topline expected mid-2026. |
|
Sozinibercept (OPT-302) |
Opthea (Australia/US) |
VEGF-C/D |
Phase 3 (Discontinued for wAMD March 2025) |
Phase 3 COAST (vs Eylea): BCVA +12.8-13.5 letters vs 13.7
(no superiority); ShORe (vs Lucentis): +12.6-13.3 letters vs 14.3 (failed).
Phase 2b: +14.2 letters vs ranibizumab alone. |
VEGFR-3 trap; combo with anti-VEGF-A for resistant nAMD;
discontinued after Phase 3 failures; Phase 3 ready for DME but no ongoing
development. |
|
XMVA09 |
Xingmou Bio (China) |
VEGF/Ang-2 |
Phase 2 |
Early Phase 2 data: BCVA +6-8 letters, CST -100-120 μm in
nAMD; Vabysmo-like safety. No new updates in 2025. |
Mimics Vabysmo; focuses on vessel stabilization for nAMD;
Phase 2 ongoing. |
|
Y400 |
China Medical System Holdings (China) |
VEGF/Ang-2 |
Phase 1/2 |
Phase 1: Safe, tolerable; efficacy data pending. No new
updates in 2025. |
Targets extended durability for nAMD/DME; early-stage
contender since 2023. |
|
ASKG712 |
AskGene Pharma (US/China) |
VEGF/Ang-2 |
Phase 1 |
Phase 1 (NCT06043489): Safe, initial CST reductions
(~80-100 μm); no serious AEs. No new updates in 2025. |
Mirrors Vabysmo; Phase 2 planned for 2026; Phase 1 ongoing
since 2023. |
|
IBI324 |
Innovent Biologics (China) |
VEGF-A/Ang-2 |
Phase 1 |
Phase 1: Safe; early anti-angiogenic activity. No new
updates in 2025. |
Builds on Vabysmo for DME; aims for longer dosing; Phase 1
ongoing since 2022. |
|
IBI333 |
Innovent Biologics (China) |
VEGF-A/VEGF-C |
Phase 1 |
Phase 1: Safe; initial VEGF inhibition signals. No new
updates in 2025. |
Targets broader VEGF family for nAMD; early-stage since
2023. |
|
Zifibancimig |
Roche (Switzerland/US) |
VEGF-A/Ang-2 |
Phase 1 |
Preclinical: Enhanced binding vs. faricimab; no human
data. ARVO 2025 characterization presented; Phase 1 ongoing (NCT04567303). |
Next-gen DutaFab bispecific; aims to surpass Vabysmo; in
development per Roche pipeline July 2025. |
- Global Innovators: Roche leads with Vabysmo (Marketed) and is developing Zifibancimig (Phase 1) for greater potency. Opthea’s OPT-302 (Phase 3) enhances existing anti-VEGF-A therapies, while Kodiak’s KSI-501 (Phase 1) targets inflammation alongside angiogenesis.
- Chinese Pioneers: Innovent’s IBI302 (Phase 3) and RC28-E (Phase 3) lead with novel pathways (complement, FGF). CMS’s Y400 (Phase 1/2), AskGene’s ASKG712 (Phase 1), and Xingmou Bio’s XMVA09 (Phase 2) advance VEGF/Ang-2 candidates, mirroring Vabysmo’s success.
Anti-VEGF Market Trends
The anti-VEGF race is shifting to innovation-driven ecosystems:
- Dual/Multi-Target Shift: Drugs like RC28-E and Vabysmo target complementary pathways, enhancing durability and reducing fibrosis.
- Biosimilars: Over 10 in China’s pipeline (e.g., Qilu’s bevacizumab (2019), aflibercept (2023), ranibizumab (2024)., and OcuMension’s OT-702) could halve costs.
- Innovative Delivery: Gene therapies (e.g., Regenxbio’s RGX-314) and implants aim to minimize injections.
- Challenges: High costs (~USD 2,000/dose for Eylea), injection burdens, and ~30% non-response rates demand personalized solutions.
Why It Matters
With China’s ophthalmic drug market at ~USD 2.1B in 2024 and projected to reach ~USD 3.9B by 2030 (GVR), the segment remains one of the country’s fastest-growing specialties. Rising diabetic eye disease and an aging population are expanding patient demand, while competition intensifies around anti-VEGF therapies.
Beyond biosimilars, the next cycle will be defined by bispecifics, sustained-release formats, and dual-target innovations that promise fewer injections and better outcomes. The RemeGen–Santen deal illustrates how Chinese companies are moving from biosimilar followers to drivers of next-gen ophthalmology innovation, using cross-border partnerships to scale regionally while keeping global ambitions alive.
Sources
- RemeGen Co., Ltd. (2025). “RemeGen Announces Licensing Agreement with Santen for RC28-E.” Company Press Release. [Available at: www.remegen.com].
- Dai, H., et al. (2025). “Phase II Clinical Trial Results of RC28-E for Diabetic Macular Edema.” Investigative Ophthalmology & Visual Science, 66(8), ARVO 2025 Abstract.
- Innovent Biologics. (2025). “IBI302 Phase II Results for nAMD.” Investigative Ophthalmology & Visual Science, 66(8), ARVO 2025 Abstract.
- Heier, J. S., et al. (2022). “Faricimab in Neovascular Age-Related Macular Degeneration: Year 2 Results From the Phase 3 TENAYA and LUCERNE Trials.” Ophthalmology, 129(8), 934-945.
- Opthea Limited. (2025). “OPT-302 Phase 2b Results and Phase 3 Trial Updates.” Ophthalmology, 132(4), 456-465.
- Khanani, A. M., et al. (2023). “KSI-501 Phase 1 Interim Results for DME.” American Journal of Ophthalmology, 247, 112-120.
- China Medical System Holdings (CMS). (2025). “Y400 Clinical Development Update.” Investor Report, HKEX: 867. [Available at: www.cms.net.cn].
- AskGene Pharma, Inc. (2025). “ASKG712 Phase I Data Update.” Press Release, PR Newswire. [Available at: www.ask-gene.com].
- Regeneron Pharmaceuticals. (2024). “Eylea 2023 Sales and Biosimilar Impact.” Annual Report. [Available at: www.regeneron.com].
- Roche. (2024). “Vabysmo Global Sales and Market Performance.” Q4 2024 Earnings Report. [Available at: www.roche.com].
- Kanghong Pharmaceutical. (2024). “Conbercept (Langmu) 2024 Sales Data.” Investor Presentation. [Available at: www.kanghongpharma.com].
- ClinicalTrials.gov. (2025). “ASKG712 Phase I Trial for nAMD/DME (NCT05940428).” [Available at: clinicaltrials.gov].
- Market Research Report. (2024). “Global Anti-VEGF Ophthalmic Market Forecast 2024-2030.” [Industry Report].
- Zhang, Y., et al. (2021). “Epidemiology of Diabetic Retinopathy and Macular Edema in China.” Journal of Diabetes Research, 2021, 1-10.
15. Innovent Biologics (2025). “Phase 2 Results of Efdamrofusp Alfa (IBI302) in nAMD at ARVO.” (Oral presentation, ARVO 2025).
16. Innovent Biologics (2025). “First Patient Dosed in Phase 3 STAR Trial of IBI302.” PR Newswire.
17. Opthea Ltd. (March 31, 2025). “Discontinued Sozinibercept Wet AMD Program After Phase 3 Failures.” (Globenewswire / RTTNews / EyesOnEyecare).
18. ClinicalTrials.gov (2025). “NCT04567303: BURGUNDY Trial of Zifibancimig (Phase I/II).”
19. Roche (2024). “BURGUNDY Trial Design: Zifibancimig in Port Delivery Platform.” (Investor Deck, ASRS 2024 / Roche pipeline).
20. Roche / ARVO (2025). “Characterization of Zifibancimig (VEGF-A/Ang-2 DutaFab).” ARVO 2025 Abstract.
21. Modern Retina / ARVO (2025). “Innovent Presents Phase 2 Data of IBI302 (Efdamrofusp Alfa).”
22. Opthea / Wikipedia (2025). “Sozinibercept Failed Phase 3 Trials — Development Terminated.”
23. Innovent / NCBI (2023). “Clinical Data of IBI302 and IBI324 Bispecific Ophthalmic Agents.”
24. ClinicalTrials.gov (2025). “ASKG712 Phase I Trial Registration (NCT05940428).”
25. NCBI / PMCID (2025). “Port Delivery Platform Used in BURGUNDY (zifibancimig) Phase I/II.”