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This is a combination therapy consisting of **rovalpituzumab tesirine**, an investigational antibody-drug conjugate (ADC) targeting delta-like protein 3 (DLL3), plus two standard cytotoxic chemotherapy agents, **cisplatin** and **etoposide**. Rovalpituzumab tesirine (Rova-T) is composed of a humanized monoclonal antibody specific for DLL3, highly expressed on small cell lung cancer (SCLC) and other neuroendocrine tumor cells, conjugated via a protease-cleavable linker to a cytotoxic pyrrolobenzodiazepine (PBD) dimer toxin. Upon binding to DLL3-expressing tumor cells, the ADC is internalized and the cytotoxic payload is released, causing DNA cross-linking and subsequent apoptosis. Cisplatin is a platinum-based chemotherapeutic that causes DNA cross-linking, while etoposide inhibits topoisomerase II, resulting in DNA strand breaks and apoptosis. The combination aims to maximize antitumor efficacy via targeted delivery with the ADC and broad cytotoxicity via standard agents. The combination has been investigated primarily in **small cell lung cancer** and neuroendocrine cancers.
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