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ProAgio + gemcitabine is an investigational combination therapy, under clinical evaluation for advanced/metastatic cancers, specifically **pancreatic ductal adenocarcinoma** and **triple-negative breast cancer**. ProAgio is a rationally designed, pegylated peptide cytotoxin that selectively targets and induces apoptosis in cells expressing **integrin αvβ3**, notably cancer-associated fibroblasts (CAFs)/pancreatic stellate cells and angiogenic endothelial cells. By depleting these stromal and vascular cells, ProAgio remodels the tumor microenvironment, reduces fibrosis, improves vessel patency, and enhances the delivery and efficacy of chemotherapeutic agents such as gemcitabine. Gemcitabine is a nucleoside analog that inhibits DNA synthesis and is a standard chemotherapeutic agent for several solid tumors. Preclinical data suggest this combination reduces stromal barriers to drug penetration and increases tumor cell apoptosis. The combination is currently being studied in Phase I/II trials in metastatic triple-negative breast cancer and in a Phase I/Ib study (including expansion cohorts) in metastatic pancreatic ductal adenocarcinoma[1][2][3][5][6].
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