The efforts add up to a new trend after Chinese pharma firms embarked on a quest to launch pivotal Phase II or III trials worldwide, especially in the US and Europe, over the past decade. Meanwhile, BeiGene, Hengrui and others are advancing late-stage programs in the US.

After the Phase III failure of xevinapant, the German group will need to cut deals and do better in a rare cancer if it is to turn its fortunes around.

Takeda has signed an option deal for Ascentage's olverembatinib, being investigated in two global Phase III trials in the same leukemia indications as those for the Japanese firm's existing drug Iclusig. Olverembatinib has also shown potential to overcome resistance to Iclusig and global competitor Novartis's Scemblix.

Companies from China single-handedly sponsored a total of eight Phase III clinical studies that included US sites in 2023 compared to six in 2022 - but the figure was still below the record of 11 in 2021.