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ADC + PD-L1 + GM-CSF + thymopentin is a multi-component combination immunotherapy regimen evaluated in the PRaG9.0 Phase II clinical trial (NCT06112041) for elderly patients with HER2-positive advanced solid tumors. The regimen consists of the HER2-targeting antibody-drug conjugate (ADC) disitamab vedotin (RC48), a PD-L1 checkpoint inhibitor, the immunostimulatory cytokine granulocyte-macrophage colony-stimulating factor (GM-CSF), and the synthetic immunomodulatory peptide thymopentin. This regimen is an extension of the PRaG platform therapy, which typically incorporates hypofractionated radiotherapy to induce an in-situ vaccine effect. The combination is designed to provide targeted cytotoxic delivery to HER2-expressing tumor cells while simultaneously stimulating a systemic anti-tumor immune response through checkpoint blockade and immune effector cell activation.
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