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**Ivonescimab + temozolomide** is an investigational combination therapy consisting of ivonescimab (AK112/SMT112), a humanized tetravalent bispecific antibody targeting programmed cell death protein 1 (PD-1) and vascular endothelial growth factor A (VEGF-A), and temozolomide, an oral alkylating chemotherapy agent. Ivonescimab simultaneously blocks PD-1-mediated immunosuppression and VEGF-mediated angiogenesis, exhibiting cooperative binding where the presence of one target enhances affinity for the other. Temozolomide induces DNA damage by alkylating/methylating DNA, which is the standard of care for glioblastoma. The combination is being evaluated in a Phase I/II clinical trial for the treatment of recurrent glioblastoma and other high-grade gliomas, aiming to leverage the synergistic effects of dual checkpoint/angiogenesis blockade and immunogenic cell death induced by chemotherapy.
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