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This combination therapy consists of disitamab vedotin (RC48-ADC) and toripalimab (JS001). Disitamab vedotin is a HER2-targeted antibody-drug conjugate (ADC) composed of a humanized anti-HER2 monoclonal antibody conjugated to the microtubule-disrupting agent monomethyl auristatin E (MMAE) via a protease-cleavable valine-citrulline linker. Toripalimab is a recombinant, humanized IgG4 monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor, blocking its interaction with PD-L1 and PD-L2 to enhance anti-tumor T-cell activity. The combination is being investigated as a perioperative (neoadjuvant and adjuvant) treatment for patients with HER2-expressing muscle-invasive bladder carcinoma (MIBC), particularly those who are ineligible for or refuse cisplatin-based chemotherapy. The rationale for the combination is to leverage the direct cytotoxic effects and potential immunogenic cell death induced by the ADC alongside the checkpoint inhibition provided by toripalimab to improve pathological complete response (pCR) rates.
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