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**Sacituzumab tirumotecan + bevacizumab** is an investigational combination therapy composed of two distinct agents: - **Sacituzumab tirumotecan**: an antibody-drug conjugate (ADC) targeting TROP2 (trophoblast cell-surface antigen 2), constructed using the same anti-TROP2 antibody as sacituzumab govitecan, but conjugated to a novel payload—a belotecan-derived topoisomerase I inhibitor—via a methyl sulfonyl pyrimidine linker. The linker allows selective payload release under the acidic and enzymatic conditions found in the tumor microenvironment. Sacituzumab tirumotecan destroys tumor cells expressing TROP2 through targeted cytotoxicity by delivering the payload intracellularly, causing DNA damage and apoptosis[2]. - **Bevacizumab**: a recombinant humanized monoclonal antibody that inhibits vascular endothelial growth factor A (VEGF-A), blocking angiogenesis required for tumor growth and maintenance. This combination is currently undergoing phase 3 clinical investigation for the treatment of advanced gynecologic malignancies, specifically fallopian tube cancer, ovarian cancer, and primary peritoneal cancer. The combination aims to leverage both targeted cytotoxicity (via TROP2-directed ADC) and inhibition of tumor-associated angiogenesis[3][4][6][10].
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