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**Spevatamig + gemcitabine + nab-paclitaxel** is a combination regimen currently under investigation for advanced and metastatic cancers, especially pancreatic ductal adenocarcinoma, gastric, gastroesophageal junction, and biliary tract carcinomas. Spevatamig (PT886) is a native IgG-like bispecific monoclonal antibody developed by Phanes Therapeutics that targets both claudin 18.2 and CD47, designed to block tumor immune evasion and enhance cytotoxicity. Gemcitabine is a nucleoside analog chemotherapy (antimetabolite) disrupting DNA synthesis. Nab-paclitaxel (nanoparticle albumin-bound paclitaxel) is a solvent-free formulation of paclitaxel, a microtubule inhibitor that disrupts mitosis and induces apoptosis in dividing cancer cells. The combination is administered intravenously and is being evaluated in a multi-cohort Phase 1/2 trial (TWINPEAK) for safety, tolerability, and clinical activity.
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