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Another B7-H3 death puts Imdelltra combo in trouble

Shortly after Amgen and Zai Lab struck a curious clinical trial collaboration to combine their respective DLL3-targeting projects, Imdelltra and zocilurtatug pelitecan, the plan to test Imdelltra combinations has run into difficulties. That’s become evident from another combo, testing Imdelltra with MediLink’s anti-B7-H3 ADC tambotatug pelitecan, whose phase 1 Dellphi-310 study has gone on hold owing to a “fatal pneumonitis event”, according to an update on the EU trials registry. The obvious connection here is with another anti-B7-H3 ADC, Daiichi Sankyo/Merck & Co’s ifinatamab deruxtecan, which spent time on clinical hold owing to deaths from interstitial lung disease. But a less obvious one is that tambota-P and Zai’s zoci-P both use MediLink’s vaunted Tmalin linker technology, and employ an identical topoisomerase inhibitor payload. It’s not clear whether there might be any class effect here, and Zai’s combo plan was followed up on Wednesday with an equally curious collaboration, seeking to test zoci-P with Boehringer Ingelheim’s anti-DLL3 T-cell engager obrixtamig. Dellphi-310 is sponsored by Amgen, which has issued no statement about its hold, presumably because this is temporary and apparently limited to six EU countries. MediLink licensed tambota-P to Roche in January.

 

Selected studies

Project 1Project 2TrialStatusNote
Imdelltra (DLL3 T-cell engager), AmgenZocilurtatug pelitecan (DLL3 ADC), Zai LabDellphi-313, +/- Imfinzi, 2nd-line ES-SCLCStarts May 2026Clinical trial collaboration announced 1 Apr 2026
Obrixtamig (DLL3 T-cell engager), Boehringer IngelheimZocilurtatug pelitecan (DLL3 ADC), Zai LabPoorly differentiated NECs & ES-SCLCTBAClinical trial collaboration announced 15 Apr 2026
Imdelltra (DLL3 T-cell engager), AmgenTambotatug pelitecan (B7-H3 ADC), MediLink/ RocheDellph1-310, +/- PD-(L)1 inhibitor in 2nd-line ES-SCLCOn hold in Italy, France, Germany, Spain, Greece & Hungary over fatal pneumonitis adverse eventClinical trial collaboration announced 7 Oct 2024
Ifinatamab deruxtecan (B7-H3 ADC), Daiichi/ Merck & CoNAIdeate-Lung02, vs chemo, 2nd-line ES-SCLCWent on global clinical hold over imbalance of grade 5 ILD events (US hold lifted)US filing accepted on basis of Ideate-Lung01 (10 Oct 2026 PDUFA date)

Source: OncologyPipeline.

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