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Zanzalintinib + XB628 is an investigational combination therapy consisting of zanzalintinib (XL092), an oral small-molecule multi-targeted tyrosine kinase inhibitor (TKI), and XB628, a bispecific antibody natural killer (NK) cell engager targeting programmed death-ligand 1 (PD-L1) and natural killer group 2 member A (NKG2A). Zanzalintinib inhibits key receptor tyrosine kinases involved in tumor growth, angiogenesis, and immune suppression, including VEGFR2, MET, and the TAM family kinases (AXL, MERTK, and TYRO3). XB628 acts as a dual checkpoint inhibitor and NK cell engager, blocking the inhibitory NKG2A receptor on NK cells and CD8+ T cells while simultaneously targeting PD-L1 on tumor cells to promote adaptive and innate immune-mediated tumor cell killing. Developed by Exelixis in collaboration with Invenra, this combination is being evaluated in a Phase 1 clinical trial (NCT06952010) for patients with recurrent advanced or metastatic solid tumors, with particular interest in colorectal cancer (CRC) and renal cell carcinoma (RCC).
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