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This is a **combination therapy** under investigation in Phase 1/2 clinical trials, composed of spevatamig (PT886), pembrolizumab, capecitabine, and oxaliplatin. - **Spevatamig (PT886)** is a first-in-class native IgG-like bispecific antibody (bsAb) developed by Phanes Therapeutics that simultaneously targets claudin 18.2 and CD47 to promote tumor cell death via immune-mediated mechanisms. - **Pembrolizumab** is a monoclonal antibody checkpoint inhibitor that blocks PD-1 on lymphocytes, facilitating an anti-tumor immune response. - **Capecitabine** is an oral prodrug that is converted to 5-fluorouracil (5-FU), inhibiting thymidylate synthase and thereby interfering with DNA synthesis in cancer cells. - **Oxaliplatin** is a platinum-based chemotherapy agent that causes DNA cross-linking and apoptosis in tumor cells. This regimen is being evaluated for advanced or metastatic **gastric adenocarcinoma**, **gastroesophageal junction adenocarcinoma**, **pancreatic ductal adenocarcinoma**, and **biliary tract carcinoma** within the TWINPEAK study. The therapeutic aim is to combine **targeted immunotherapy** and **cytotoxic chemotherapy** for synergistic anti-tumor effect[2][4][6][8].
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