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A combination anti-cancer regimen consisting of four investigational and approved agents: **zimberelimab** (a fully human anti-PD-1 monoclonal antibody), **domvanalimab** (an Fc-silent anti-TIGIT monoclonal antibody), **sacituzumab govitecan-hziy** (a Trop-2-directed antibody-drug conjugate containing a SN-38 payload), and **etrumadenant** (an oral dual A2a/A2b adenosine receptor antagonist). This combination is in clinical development, primarily for the treatment of advanced solid tumors, including non-small cell lung cancer. Each component employs a distinct immuno-oncology mechanism to enhance anti-tumor immune responses and directly target tumor cells. Arcus Biosciences and its partners are the primary developers; sacituzumab govitecan-hziy (marketed as Trodelvy) is approved for breast cancer and developed by Gilead.
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