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Onfekafusp alfa + dacarbazine is an investigational anticancer combination therapy studied primarily in advanced or metastatic soft tissue sarcoma. Onfekafusp alfa (also known as L19-TNF or Fibromun) is a fully human antibody–cytokine fusion protein, consisting of an anti–extra domain-B (EDB) human antibody (L19) fused to human tumor necrosis factor alpha (TNF-α). The L19 antibody targets the EDB domain of fibronectin, selectively localizing TNF activity to tumor neovasculature, thereby increasing vascular permeability and potentiating immune-mediated and direct cytotoxic tumor cell killing. Dacarbazine (DTIC) is a standard chemotherapeutic alkylating agent that induces DNA damage in proliferating cells. The combination aims to exploit complementary mechanisms: TNF-mediated vascular disruption and immune potentiation (onfekafusp alfa), and direct cytotoxicity (dacarbazine), with the goal of improving therapeutic efficacy in sarcoma and possibly other tumoral indications[1][3][4][5].
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