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Sintilimab + Ipilimumab + AG is an investigational combination regimen being evaluated as a first-line therapy for unresectable locally advanced or metastatic biliary tract malignancies. The regimen consists of two monoclonal antibodies—sintilimab (a PD-1 inhibitor) and ipilimumab (a CTLA-4 inhibitor)—and two chemotherapy agents—albumin-bound paclitaxel (nab-paclitaxel) and gemcitabine (collectively known as the AG regimen). Sintilimab is a fully human IgG4 monoclonal antibody that blocks the PD-1/PD-L1 interaction, while ipilimumab is a human IgG1 monoclonal antibody that targets CTLA-4. The combination of dual checkpoint blockade with cytotoxic chemotherapy is designed to enhance anti-tumor immune responses and provide direct cytotoxic effects. This four-drug protocol is currently being studied in a Phase II clinical trial sponsored by Tianjin Medical University Cancer Institute and Hospital.
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