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IDE849 + IDE161 is an investigational, first-in-class combination therapy being developed by IDEAYA Biosciences for the treatment of DLL3-upregulated solid tumors, including small cell lung cancer (SCLC), neuroendocrine tumors (NETs), neuroendocrine carcinomas (NECs), and melanoma. The combination consists of IDE849 (also known as SHR-4849), a delta-like ligand 3 (DLL3)-targeting antibody-drug conjugate (ADC) carrying a topoisomerase-1 (TOP1) inhibitor payload, and IDE161, an oral small-molecule inhibitor of poly(ADP-ribose) glycohydrolase (PARG). IDE161 blocks the removal of poly(ADP-ribose) chains generated during the DNA damage response, leading to persistent PARylation and impaired resolution of DNA repair complexes. This mechanism of action is designed to induce the accumulation of TOP1 lesions, thereby enhancing the anti-tumor efficacy and durability of the TOP1-payload ADC, IDE849. The combination is currently being evaluated in a Phase 1 clinical trial.
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