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muzastotug + pembrolizumab + fruquintinib is an investigational triple combination regimen being evaluated for the treatment of late-line, microsatellite-stable (MSS) metastatic colorectal cancer (CRC). The regimen combines muzastotug (ADG126), a masked anti-CTLA-4 IgG1 monoclonal antibody developed by Adagene; pembrolizumab (Keytruda), an anti-PD-1 monoclonal antibody developed by Merck & Co.; and fruquintinib (Fruzaqla), an oral small molecule inhibitor of VEGFR-1, -2, and -3 developed by HUTCHMED and Takeda. Muzastotug is designed for tumor-selective activation via protease-mediated cleavage in the tumor microenvironment, which widens its therapeutic index, partially blocks CTLA-4 signaling, and selectively depletes intratumoral regulatory T cells (Tregs). The combination of CTLA-4 and PD-1 checkpoint inhibition with the anti-angiogenic effects of fruquintinib is intended to provide synergistic anti-tumor activity, particularly in patients with liver metastases. The triplet is being evaluated in the Phase 1b/2 clinical trial NCT05405595.
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