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Vilastobart is an investigational, tumor-activated, Fc-enhanced, high-affinity binding anti-CTLA-4 monoclonal antibody developed by Xilio Therapeutics. It is designed to block CTLA-4 and deplete regulatory T cells (Tregs) when activated in the tumor microenvironment. The molecule remains masked until it reaches the tumor site, where it is unmasked by proteases present in the tumor microenvironment. This selective activation aims to improve safety and efficacy compared to traditional CTLA-4 inhibitors by reducing immune-related adverse events outside tumors. Vilastobart has demonstrated promising activity in early clinical trials for advanced solid tumors—including metastatic microsatellite stable colorectal cancer (MSS CRC), gastric cancer, non-small cell lung cancer (NSCLC), pancreatic cancer, breast cancer, head and neck cancer, renal cell carcinoma, uterine cancer, small-cell lung cancer, metastatic castration-resistant prostate cancer (mCRPC), merkel cell carcinoma, cervical cancer, esophageal cancer, prostate cancer, fallopian tube cancer, leiomyosarcoma and metastatic melanoma[1][5][7][8]. Its mechanism of action includes blocking CTLA-4 checkpoint signaling and driving potent antibody-dependent cell-mediated cytotoxicity (ADCC) against Tregs that highly express CTLA-4 within tumors[1][6].
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