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This combination therapy pairs nanoliposomal irinotecan, a cytotoxic topoisomerase I inhibitor, with cadonilimab (AK104), a first-in-class PD-1/CTLA-4 bispecific antibody. Nanoliposomal irinotecan utilizes a liposomal delivery system to improve the pharmacokinetics and tumor accumulation of irinotecan's active metabolite, SN-38, thereby reducing systemic toxicity compared to conventional irinotecan. Cadonilimab simultaneously blocks the Programmed Cell Death Protein 1 (PD-1) and Cytotoxic T-Lymphocyte Associated Protein 4 (CTLA-4) immune checkpoints, enhancing T-cell activation and anti-tumor immunity. The combination is primarily being evaluated for the treatment of small cell lung cancer (SCLC), particularly in patients who have progressed on prior platinum-based therapies, aiming to leverage the synergistic effects of chemotherapy-induced immunogenic cell death and dual checkpoint inhibition.
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