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**Tuvusertib + PLX038** is a combination therapy under investigation for the treatment of advanced solid tumors, including neuroblastoma and other neoplasms. Tuvusertib is an oral ATR (Ataxia Telangiectasia and Rad3-related) inhibitor that impairs the DNA damage response pathway, thereby sensitizing cancer cells to DNA-damaging agents[1][9]. PLX038 is a long-acting, PEGylated prodrug of SN-38, the active metabolite of irinotecan and sacituzumab govitecan; it is a potent topoisomerase I inhibitor that induces replication stress and DNA damage leading to tumor cell death[5][2][6]. This combination exploits synthetic lethality in tumors with DNA repair defects and may enhance the efficacy of DNA damage response pathway inhibitors. The therapy is in phase I clinical trials with planned expansion cohorts for further efficacy and safety evaluation[1][7][9].
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