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INBRX-109 + irinotecan + temozolomide is an experimental **three-drug combination regimen** developed for oncology indications, most notably being investigated in **Ewing sarcoma**. INBRX-109 (ozekibart) is a precision-engineered, recombinant, humanized tetravalent monoclonal antibody that functions as a death receptor 5 (DR5) agonist, designed to induce tumor-biased apoptosis via activation of DR5—a pro-apoptotic receptor for tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Irinotecan is a topoisomerase I inhibitor, and temozolomide is an oral DNA-alkylating agent in the imidazotetrazine class. The combination seeks to leverage targeted pro-apoptotic signaling with INBRX-109, plus the cytotoxic properties of irinotecan and temozolomide. This triplet is under active investigation in clinical trials for relapsed or refractory Ewing sarcoma and potentially other solid tumors, but is not an approved regimen for any indication[4].
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