SYM021 + SYM023 + irinotecan

SYM021 + SYM023 + irinotecan is an investigational combination therapy being studied for the treatment of recurrent advanced solid tumor malignancies, specifically **biliary tract carcinomas** and **esophageal squamous cell carcinoma**. SYM021 is a humanized monoclonal antibody targeting **Programmed cell death protein 1 (PD-1)**, while SYM023 is a monoclonal antibody targeting **T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3)**. Irinotecan is a well-established cytotoxic **small molecule chemotherapeutic agent** that inhibits **Topoisomerase I**, leading to DNA damage and apoptosis in cancer cells. The rationale for this combination is to simultaneously block immune checkpoint pathways involved in tumor immune evasion (PD-1 and TIM-3) and to provide direct cytotoxic activity with irinotecan. The combination is administered intravenously in a specific sequential infusion protocol[1][3][5].