RELIGHT: PIII 1L gastric cancer 🇨🇳, now published in JCO. "Positive", but put it next to CheckMate and it suddenly loses its luster. Retlirafusp is a PD-L1/TGF-B bispecific. The study randomized 731 patients with HER2-negative gastric/GEJ adenocarcinoma to retlirafusp + CAPOX vs placebo + CAPOX. OS 16.8 vs 10.4 mo, HR 0.53 PFS 7.6 vs 5.5 mo, HR 0.52 Looking at the Chinese cohort in CheckMate-649, CPS ≥5 cohort (nivo + chemo vs chemo) results are strikingly similar: OS 15.5 vs 9.6 mo, HR 0.54 PFS 8.5 vs 4.3 mo, HR 0.52 Given a plain PD-1 inhibitor produced essentially the same hazard ratios here it is hard to see what TGF-β is adding. Chemo alone hasn't been standard for years, and the authors acknowledge the protocol was locked before PD-1 + chemo became SoC in China. RELIGHT shows retlirafusp beats chemo; we already knew that. Why am I posting about it? Well, it is another striking example that China has woken up to clinical trials and is running laps around the rest of the world in terms of speed, cost and efficiency. Anyone who has watched a trial sit in contracting for months knows reform is overdue (someone please teach me how to efficiently move legal forward). @OncoAlert @TheGutOncLab @Onco_Nexus