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Istiratumab is a fully human bispecific monoclonal antibody that targets both the insulin-like growth factor 1 receptor (IGF-1R) and the epidermal growth factor receptor ErbB3 (HER3). By binding to IGF-1R, it blocks the interaction with its natural ligands IGF-1, IGF-2, and heregulin, while its anti-ErbB3 arm prevents neuregulin from activating ErbB3. This dual blockade inhibits activation of the PI3K/AKT/mTOR signaling pathway, leading to reduced tumor cell proliferation and increased apoptosis in cancers overexpressing these receptors. Istiratumab was developed primarily for oncology indications such as pancreatic cancer and other solid tumors. It was granted orphan drug status for pancreatic cancer but development has been discontinued[2][3][5][7].
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