China’s NMPA accepted the NDA for opamtistomig (LBL-024), a PD-L1/4-1BB bispecific antibody, granting priority review for pretreated advanced extrapulmonary neuroendocrine carcinoma (EP-NEC). The application is supported by a registrational study that enrolled 96 patients across 34 sites, with previously reported ORR of 33.3% in EP-NEC. In parallel, academic researchers reported a locally targeted CAR-T approach intended to reduce toxicity while addressing tumor heterogeneity. The strategy has CAR T cells engineered to secrete anti-EpCAM bispecific T-cell engagers at the tumor site, aiming to preserve activity against EpCAM-positive tumor cells while avoiding systemic exposure to normal tissues. Both developments reinforce the field’s push beyond checkpoint inhibition toward controlled immune activation and spatially constrained immunotherapies.