U.S. cancer patients are flying to China for drugs they cannot yet get at home
For some Americans with advanced cancer, the shortest path to a new therapy now runs through Shanghai. The clearest example is sunvozertinib, a targeted lung cancer drug developed in China that has already changed treatment decisions for patients whose tumors carry a rare mutation and who have run out of standard options in the United States.
Debbie Doppelt’s case shows how quickly the calculus can shift when a cancer evolves faster than the U.S. regulatory system. She is a 60-year-old jeweler with an unusual form of lung cancer that is more common in nonsmokers. After chemotherapy and surgery, her cancer spread to her brain, and she could not enter the relevant clinical trials. The FDA had not yet approved sunvozertinib when her family began searching for alternatives, and the other available drugs either carried concerns about toxicity or seemed less likely to reach brain metastases.
One offhand remark changed the trajectory of her care. A doctor told her son Max Doppelt, “Too bad she’s not Chinese. She could go to a pharmacy in China and buy it.” Within hours, the family had arranged a supply through contacts with ties to China. A few months later, Max flew to Shanghai to secure a refill.
A single sentence opened a global detour for a patient who had already exhausted the usual American playbook.
Sunvozertinib filled a gap left by trial ineligibility and brain metastases
The clinical problem was not abstract. Doppelt’s disease had advanced despite prior treatment, and imaging in December 2024 showed 10 tiny brain tumors. Her family had considered amivantamab, which the FDA approved earlier that year for the mutation driving her cancer, but they worried about toxicity and about whether the drug would penetrate brain tissue well enough to control intracranial disease. A separate attempt to enter a Memorial Sloan Kettering trial of zipalertinib failed when lung scarring made her ineligible.
That sequence matters because targeted lung cancer therapy depends on matching the biology of the tumor to the drug’s mechanism. Once a driver mutation is identified, treatment becomes a search for the most precise inhibitor, not just the strongest chemotherapy. In the setting of brain metastases, the question becomes even sharper: a drug can look useful on paper and still fail if it does not get where the cancer has spread.
Sunvozertinib had already been approved in China in 2023 and was being tested in the United States, but the American trial structure did not suit Doppelt’s situation. In late-stage studies, half the participants would receive chemotherapy alone. For a patient whose cancer had already advanced past chemotherapy, that was not a viable gamble.
Max Doppelt said he knows of at least 30 Americans who have gone to China for the same drug. He also said the medication cost about $10,000 for the 26 boxes he brought home in his luggage. The family’s experience is unusual, but the underlying need is not: patients with metastatic cancer often cannot wait for the slower end of the regulatory pipeline when a potentially active drug already exists elsewhere.
China’s rise in biotech is reshaping where early cancer innovation happens
China is no longer just a source of precursor chemicals and generic drugs. It has become a major site for drug development, and U.S. companies are increasingly running studies there or partnering with Chinese firms. The article points to China accounting for as much as 46% of new drugs tested worldwide in 2025, a figure that helps explain why patients and sponsors alike are paying attention.
Several forces are pushing the change. Venture capital is flowing into early-stage clinical work in China and Australia because regulatory systems there can move first-in-human studies faster than in the United States. Biotech leaders interviewed in the article described a shift in behavior as well: American companies that once shared early findings more openly now conceal progress out of fear that competitors will move faster abroad.
This is not merely an industrial story. Faster early-phase research can change which patients reach a treatment before their disease becomes untreatable. When a drug appears promising against a driver mutation, the gap between scientific discovery and patient access can determine whether a person is alive when the therapy finally arrives.
Heidi Overton, President Donald Trump’s nominee to lead the FDA, called current requirements “slow and prohibitive” and warned that moving trials overseas threatens U.S. health security. The administration’s Operation TrialBlazer is meant to speed regulatory processes and keep more studies in the country. At the same time, members of Congress are pressing in the opposite direction, seeking tighter scrutiny of U.S. pharmaceutical deals with Chinese companies.
Patient advocates are using China as a stopgap, not a destination
For families like the Doppelts, the China route is less a geopolitical statement than a practical response to disease progression. Their options are shaped by whether a drug has U.S. approval, whether a trial has room, whether toxicity is acceptable, and whether the cancer has spread to the brain or another sanctuary site. When those conditions line up against the patient, borders become clinically relevant.
Max Doppelt has since redirected his energy into helping other patients find trials. He left his tech job and launched a company using artificial intelligence to match patient records with research and drug company databases. About 300 patients have used the app so far, most of them with lung cancer. The broader push reflects a familiar oncology problem: only about 7% of U.S. cancer patients currently enter clinical trials, and many never find the studies that might fit their disease biology.
For Doppelt, the drug has bought time. Nineteen months after starting sunvozertinib, her cancer was still mostly controlled, with some radiation and dose adjustments. But neither she nor her son treats that response as permanent. Her cancer can evolve resistance, and future treatment may depend on the next mutation-specific drug, wherever it is developed.
Max said he would rather see those medicines developed in the United States. He also rejected the idea of shutting Chinese biotech out of the system. In his view, lives are tied to speed, not nationality, and the patient is the one waiting for the next answer when the current answer stops working. The article closes on that unresolved pressure point: American drug policy, Chinese innovation, and the clinical reality that metastatic cancer rarely pauses for politics.