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This combination therapy regimen is a multi-modal treatment approach being investigated for the treatment of microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) locally advanced gastric and gastroesophageal junction (GEJ) adenocarcinomas. The regimen consists of **QL1706** (a bifunctional combination of the anti-PD-1 monoclonal antibody **iparomlimab** and the anti-CTLA-4 monoclonal antibody **tuvonralimab**), the multi-targeted tyrosine kinase inhibitor **lenvatinib**, and the **SOX** chemotherapy regimen (comprising the oral fluoropyrimidine **S-1** and the platinum-based agent **oxaliplatin**). The combination aims to leverage synergistic effects between dual checkpoint inhibition, anti-angiogenesis, and cytotoxic chemotherapy to achieve tumor downstaging and conversion to resectability in patients with potentially resectable tumors. Iparomlimab and tuvonralimab are biologics developed by Qilu Pharmaceutical, while lenvatinib is a small molecule kinase inhibitor, and S-1 and oxaliplatin are standard chemotherapy agents.
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