Phase 2 ivonescimab PD-1×VEGF bispecific antibody consolidation after SBRT in early NSCLC

Memorial Sloan Kettering Cancer Center is running I-PRECISE, a Phase 2 study asking whether adding ivonescimab after definitive stereotactic body radiotherapy (SBRT)—delivered with either photon or proton techniques—can improve outcomes for early-stage, unresectable non-small cell lung cancer (NSCLC). Patients receive SBRT as usual care, then start consolidation ivonescimab about 4–6 weeks later on 21-day cycles; ivonescimab is a dual-targeting bispecific antibody designed to block PD-1 immune checkpoint signaling and VEGF-mediated angiogenesis. The key population is early-stage NSCLC without EGFR or ALK alterations, a group where targeted TKIs are not relevant and relapse prevention after local therapy remains a major need. The scientific angle is the “local control + systemic immune/anti-angiogenic consolidation” strategy—conceptually analogous to how consolidation immunotherapy changed unresectable stage III NSCLC, but here tested after ablative SBRT in earlier-stage disease. Today’s care for medically inoperable early-stage NSCLC is curative-intent SBRT alone (photon or, in select centers, proton), with no widely adopted post-SBRT systemic consolidation standard.