tiragolumab + atezolizumab + carboplatin + pemetrexed

This is a **four-drug combination therapy** for cancer comprising tiragolumab, atezolizumab, carboplatin, and pemetrexed. - **Tiragolumab** is a fully humanized monoclonal IgG1 antibody targeting TIGIT (T-cell immunoreceptor with Ig and ITIM domains), acting as an immune checkpoint inhibitor and enhancing anti-tumor T cell responses by blocking TIGIT-mediated immunosuppression[3][5]. - **Atezolizumab** is a monoclonal antibody against PD-L1 (programmed death ligand-1) that inhibits the interaction between PD-L1 and its receptors, thereby promoting immune activation against tumors[1][3][5]. - **Carboplatin** is a small molecule platinum-based alkylating agent that induces DNA crosslinking, leading to apoptosis in cancer cells. - **Pemetrexed** is a small molecule antifolate antimetabolite that inhibits multiple folate-dependent enzymes essential for nucleotide synthesis and cell replication. The rationale for the combination is to leverage both dual immune checkpoint blockade (TIGIT/PD-L1) and cytotoxic chemotherapy for synergistic anti-tumor effects, primarily investigated in non-small cell lung cancer (NSCLC)[1][5]. Roche has led the main development efforts for tiragolumab and atezolizumab[3][5].