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This combination therapy consists of ipalolitovolimab (JS004), tuvonralimab (toripalimab; JS001), and lenvatinib. Ipalolitovolimab is a first-in-class recombinant humanized monoclonal antibody targeting B- and T-lymphocyte attenuator (BTLA), a co-inhibitory molecule expressed on T and B lymphocytes that negatively regulates immune responses. Tuvonralimab is a humanized monoclonal antibody directed against the programmed cell death protein 1 (PD-1) receptor, designed to block the interaction between PD-1 and its ligands (PD-L1 and PD-L2), thereby restoring T-cell mediated anti-tumor activity. Lenvatinib is an oral multi-kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR1-3), fibroblast growth factor receptors (FGFR1-4), platelet-derived growth factor receptor alpha (PDGFRα), KIT, and RET. The combination is being investigated, particularly by institutions like Zhejiang Tumor Hospital, for the treatment of advanced malignancies such as pleural mesothelioma, aiming to leverage the synergistic effects of dual checkpoint inhibition (BTLA and PD-1) alongside anti-angiogenic and multi-kinase inhibition.
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