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NGR-hTNF is a recombinant fusion protein consisting of human tumor necrosis factor alpha (hTNF-α) linked to the NGR (asparagine-glycine-arginine) peptide. The NGR peptide selectively targets the CD13 (aminopeptidase N) isoform expressed on the neo-vasculature of tumors. By delivering low doses of TNF-α specifically to the tumor environment, it alters vascular permeability and the tumor microenvironment, thereby enhancing the penetration of co-administered chemotherapeutic agents and promoting T-cell infiltration. In the context of malignant pleural mesothelioma, it was evaluated in combination with Best Investigator's Choice (BIC), which included single-agent doxorubicin, gemcitabine, or vinorelbine. Although the Phase III NGR015 trial did not meet its primary endpoint, the drug demonstrated a favorable safety profile.
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