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Legusanquimod (QHL-109) is a tumor microenvironment (TME)-activated prodrug of a Toll-like receptor 7/8 (TLR7/8) agonist, specifically a derivative of resiquimod. Developed by Shanghai Qinheli Biotechnology, the drug utilizes the company's proprietary "Lego" platform, which conjugates the active TLR agonist moiety to a peptide linker (Leu-Leu-Ala-Ala-Asn) designed for selective cleavage by legumain. Legumain is an asparaginyl endopeptidase that is highly overexpressed in the TME of various solid tumors, including bladder cancer. By remaining inactive in systemic circulation and selectively releasing the potent immune stimulant within the tumor site, legusanquimod aims to induce a robust localized innate and adaptive anti-tumor immune response while minimizing systemic immune-related toxicities. It is currently being evaluated in Phase Ib/IIa clinical trials as an intravesical therapy for patients with non-muscle-invasive bladder cancer (NMIBC) who have failed or are unresponsive to standard Bacillus Calmette-Guérin (BCG) therapy.
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