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ICOS (Inducible T-cell COStimulator, CD278) agonist antibodies are a class of immunotherapeutic agents designed to enhance anti-tumor immune responses by stimulating the ICOS receptor, a member of the CD28 superfamily expressed on activated T cells. Agonism of ICOS promotes T-cell proliferation, survival, and the production of effector cytokines, including IL-4 and IL-10. In oncology, these antibodies are primarily investigated for their ability to activate CD8+ and CD4+ effector T cells, often in combination with PD-1/PD-L1 checkpoint inhibitors or radiation therapy to overcome immunosuppressive tumor microenvironments. Preclinical research has also identified a potential role for ICOS agonist antibodies in the resolution of chemotherapy-induced peripheral neuropathy (CIPN) and other neuropathic pain states through an IL-10-mediated mechanism. Several candidates have entered clinical development, including feladilimab (GSK3359609) and vopratelimab (JTX-2011), although some late-stage programs have faced clinical challenges.
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