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CTX-009 + paclitaxel is a combination therapy under investigation for advanced biliary tract cancer (BTC). CTX-009 is a bispecific monoclonal antibody that simultaneously targets **Delta-like ligand 4 (DLL4)** in the Notch signaling pathway and **vascular endothelial growth factor A (VEGF-A)**, blocking two key drivers of tumor angiogenesis. Paclitaxel is a microtubule-stabilizing chemotherapeutic agent that inhibits cell division. The combination has demonstrated a notable response rate in clinical trials of patients with previously treated, unresectable or metastatic BTC, with manageable toxicity and durable responses. The combination is being developed principally as a second-line therapy after failure of standard regimens.
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