Compugen (CGEN) Leerink Global Healthcare Conference 2026 summary

Rilvegostomig (TIGIT bispecific) clinical program

• AstraZeneca is conducting 11 phase III trials with rilvegostomig, using it both as a novel IO backbone and in direct comparison to PD-1/PD-L1 inhibitors, with about half not directly comparing to pembrolizumab.

• The bispecific antibody format, high-affinity TIGIT component, and Fc-reduced design are believed to offer improved efficacy and safety over previous TIGIT approaches.

• Novel combinations, such as with TROP-2 ADC and claudin 18.2 ADC, are being tested, with patient stratification based on biomarkers like PD-L1 and TROP-2 QCS.

• The TROPION-Lung10 trial is the only one focusing on the TROP-2 QCS biomarker population, using AI-based digital pathology for patient selection.

• Phase III readouts are expected after 2027, with non-phase III data anticipated in 2026 and 2027.

Scientific rationale and industry context

• The bispecific format enables cooperative binding and enhanced activity in ex vivo patient-derived systems compared to separate PD-1 and TIGIT blockade.

• Failures of previous TIGIT antagonists are attributed to drug format, patient selection, and trial design rather than inherent redundancy with PD-1 or ligand biology.

• Success is expected to depend on selecting the right patient populations (e.g., PD-L1 high), using Fc-reduced formats, and powering trials appropriately.

COM701 (PVRIG antagonist) and MAIA ovarian trial

• The MAIA trial targets platinum-sensitive ovarian cancer patients in second or third line, excluding those with liver metastasis, to test COM701 monotherapy versus placebo.

• PVRIG is highly expressed in ovarian cancer, particularly on stem-like memory T cells, and COM701 has shown the ability to drive T cell infiltration in less inflamed tumors.

• Prior phase I data in platinum-resistant patients showed clinical benefit, especially when excluding those with liver metastasis.

• The trial is designed to set a high bar for monotherapy activity, with potential for accelerated approval or expansion into combinations or broader populations if successful.