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ALX-0651 is a biparatopic nanobody (Nb) therapeutic consisting of two monovalent nanobodies targeting different epitopes of the chemokine receptor CXCR4. It was developed by Ablynx, which became a subsidiary of Sanofi. The drug acts as an antagonist of CXCR4, a G protein-coupled receptor involved in hematopoietic stem cell trafficking and implicated in cancer progression and metastasis. Preclinical data suggested that ALX-0651 could block CXCR4-mediated viral entry and induce rapid stem-cell mobilization. It was the first nanobody to enter clinical trials targeting a GPCR, with initial development focused on oncology indications such as non-Hodgkin's lymphoma and multiple myeloma. Clinical development reached phase I but has since been discontinued[1][2][3][5][8].
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