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MT-6402 is a third-generation engineered toxin body (ETB) developed by Molecular Templates. It is designed to target and eliminate PD-L1-expressing tumor and immune cells in patients with advanced solid tumors, including non-small cell lung cancer (NSCLC) and head and neck squamous cell carcinoma (HNSCC). The drug consists of an immunoglobulin fragment that binds PD-L1 fused to a de-immunized Shiga-like toxin A subunit (SLTA), which irreversibly inhibits ribosomal function upon internalization, leading to direct cytotoxicity. Additionally, MT-6402 delivers an HLA-A*02-restricted cytomegalovirus (CMV) class I antigen into PD-L1+ cells ("antigen seeding"), enabling recognition by CMV-specific cytotoxic T cells. Its mechanisms include direct tumor cell kill, depletion of immunosuppressive myeloid-derived suppressor cells (MDSCs), remodeling the tumor microenvironment to restore T-cell surveillance, and enhancing immune recognition through antigen seeding[1][2][5][8].
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