China’s NMPA has accepted the NDA for opamtistomig (LBL-024) as monotherapy in previously treated advanced extrapulmonary neuroendocrine carcinoma. The agency granted priority review, and the filing is backed by a registrational study led by Lin Shen, MD, of Peking University Cancer Hospital across 96 patients. Opamtistomig is a PD-L1/4-1BB–directed bispecific designed to block PD-L1–mediated immune suppression while conditionally activating 4-1BB agonist signaling. The company positions it as the first globally to directly target 4-1BB via a bispecific platform and as the first approved agonistic antibody would be evaluated against existing checkpoint axes. The decision keeps focus on costimulatory receptor agonism—particularly in immunologically “cold” tumor types with limited approved options—while highlighting NMPA’s continued willingness to expedite registrational pathways for oncology candidates.