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A combination therapy being investigated for advanced/metastatic Claudin 18.2–positive gastric and esophageal cancers, consisting of **givastomig** (a bispecific antibody targeting Claudin 18.2 and 4-1BB), **nivolumab** (a PD-1 immune checkpoint inhibitor), and **chemotherapy** (commonly FOLFOX or CAPOX regimens). Givastomig is designed to bind to tumor cells expressing Claudin 18.2 and to activate T cells specifically within the tumor microenvironment via 4-1BB, enhancing anti-tumor immune responses while minimizing systemic toxicity. The combination is intended as a first-line treatment and is in Phase 1b/2 development. Nivolumab is approved in combination with chemotherapy for metastatic gastric cancer and works by inhibiting PD-1, leading to enhanced T cell-mediated antitumor activity[2][4][6].
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