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monalizumab + volrustomig is an investigational combination immunotherapy regimen being evaluated for the treatment of metastatic solid tumors characterized by microsatellite instability (MSI) or deficient mismatch repair (dMMR). Monalizumab is a humanized IgG4 monoclonal antibody that targets the NKG2A receptor, an inhibitory checkpoint expressed on natural killer (NK) cells and cytotoxic T lymphocytes. By blocking the interaction between NKG2A and its ligand HLA-E, monalizumab enhances both innate and adaptive anti-tumor immunity. Volrustomig (MEDI5752) is a bispecific monoclonal antibody that simultaneously targets the programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte protein 4 (CTLA-4) pathways. This dual blockade is designed to improve T-cell activation and infiltration into the tumor microenvironment. The combination is currently being investigated in a Phase II clinical trial sponsored by Assistance Publique - Hôpitaux de Paris (AP-HP) to determine if the synergistic effect of targeting three distinct immune checkpoints can overcome resistance to standard-of-care PD-1 inhibitors in immunogenic MSI/dMMR cancers.
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