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FS118 is a first-in-class tetravalent bispecific antibody designed to target and bind both lymphocyte activation gene 3 protein (LAG-3; CD223) and programmed cell death ligand 1 (PD-L1; CD274). By simultaneously blocking these two immune checkpoint pathways, FS118 aims to reverse immune suppression in the tumor microenvironment and reinvigorate exhausted T cells. This dual blockade is intended to overcome resistance mechanisms that arise with PD-(L)1 inhibitor therapies alone. Mechanistically, FS118 mediates shedding of LAG-3 from the surface of immune cells via ADAM10 and ADAM17 metalloproteinases upon simultaneous binding to both targets. The drug has demonstrated encouraging clinical activity in heavily pre-treated cancer patients who have developed resistance to prior PD-(L)1 therapy. It is being developed primarily for advanced cancers such as diffuse large B cell lymphoma, head and neck cancer, and non-small cell lung cancer[1][2][5][6][7].
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