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Article History

Received: 20 September 2025

Revised: 12 February 2026

Accepted: 24 March 2026

First Online: 8 April 2026

Competing interests

: YD received institutional research funding from Shattuck Labs for this study. She also reports institutional research funding from GlaxoSmithKline and AstraZeneca, and honoraria for educational meetings or serving in an advisory role for Merck, AbbVie, GlaxoSmithKline, and AstraZeneca. LG received institutional research funding from Shattuck Labs for this study. She also reports institutional grants from Alkermes, Ascendis, AstraZeneca, Bayer, CanariaBio Inc, Corcept Therapeutics, Daiichi Sankyo Inc, Eisai, Espersas, Fortrea Inc, GmbH, GOG Foundation, GSK, ImmunoGen, IMV, K-Group Beta Inc, Karyopharm, Merck, Mersana Therapeutics, Novocure, OncoQuest Pharmaceuticals, Paraxel International, Pfizer, Pri-Wex Pharma Inc, Repare Therapeutics, Roche, Seagen Inc, Sichuan Kelun Biotech Biopharma, Parexel, Sutro Bio Pharma, and Tesar. She reports honoraria for Advisory Board Meetings from CabaruaBio Inc., Corcept Therapeutics, Eisai, GSK, ImmunoGen, Karyopharm, Kora Health Care, Merck, Novocure and Repare Therapeutics. AMB received institutional research funding from Shattuck Labs for this study. He also reports honoraria for consulting from GSK, AstraZeneca and Novartis. AO (Ana Oaknin) received institutional research funding from Shattuck Labs for this study. She also reports consulting fees for serving in an advisory role for AbbVie Inc., Agenus, AstraZeneca, Clovis Oncology, Corcept Therapeutics, Deciphera Pharmaceuticals, Daïichi Sankyo, Debiopharm International, Eisai, Exelixis, F. Hoffmann-La Roche, Genmab, GSK, ImmunoGen, Itheos, MSD, Mersana Therapeutics, Myriad Genetics, Novocure, OncoXerna Therapeutics, Inc., PharmaMar, Regeneron, ShattuckLabs, Seagen/Pfizer, Stemline Therapeutics, Sutro Biopharma, TORL Therapeutics, Zentalis and Zymeworks. She also received honoraria from NSGO, Peerview, Peervoice, Medscape, Asociación Colombiada de Ginecológos Oncólogos, ESO. VM received institutional research funding from Shattuck Labs for this study. He also reports institutional research funding from AbbVie, Achilles, Adaptimmune, Adc Therapeutics, Ascendis Pharma, AstraZeneca, Bayer, Beigene, Bicycle Tx, Bioinvent, Biomea Fusion, Biontech, Bms, Boehringer, C4 Therapeutics, Calico Life Sciences Llc, Celgene, Constellation, Crescendo Biologics, Cullinan, Daiichi Sankyo, Debiopharm, Dragonfly, Enliven Therapeutics, Epizyme, Exelixis, Famewave, F-Star Beta Limited, Genentech, Genmab, Gilead, Grey Wolf Therapeutics, GSK, Hexal Ag & Sandoz, Hifibio, Hookipa Biotech, Hutchmed, Igm Biosciences, Imcheck Therapeutics, Immunocore, Immutep, Incyte Iomx Therapeutics, Iovance, Italfarmaco, Iteos, Janssen, Light Chain Bioscience, Lilly, Loxo Oncology, Merck, Merus, Miltenyi Biomedicine, Monta Biosciences, Msd, Mythic Therapeutics, Ningbo Newbay, Novartis, Oxford Biotherapeutics, Pfizer, Pharmamar, Pmv Pharma, Prelude Therapeutics Inc, Pyxis Oncology, Regeneron, Relay Terapeutics, Repare Therapeutics, Revolution, Roche, Schrödinger, Scorpion Therapeutics, Seagen, Synthorx, Takeda, Tango Therapeutics, Tesaro, Totus Medicines, Turning Point Therapeutics, Vividion Therapeutics. He has consulted and received fees from AbbVie, Roche, Bayer, BMS, Janssen, Syneos, Affimed, Astra Zeneca, Merck, Ellipses Pharma. LGG received institutional research funding from Shattuck Labs for this study. She also received consulting fees from AbbVie, AstraZeneca, Clovis Oncology, Daiichi Sankyo, GSK, MSD, Pharma&, and PharmaMar. GCJ received institutional research funding from Shattuck Labs for this study. He also reports honoraria for educational events from GSK, PHARMA, AstraZeneca, and Novartis, and institutional funding for investigator led research from AstraZeneca. RK received institutional research funding from Shattuck Labs for this study. She also reports honoraria for educational meetings or for serving as an advisor for Abbvie, AstraZeneca, Duke Street Bio, Eisai, Epsilogen, Genmab, GSK, Immunogen, Incyte, Leucid Bio, Lilly, MSD Pharma&, and Tubulis. NL received institutional research funding from Shattuck Labs for this study. He also reports institutional research funding from Adcentryx, Alexion, Alkermes, Alkermes/Mural Oncology, Alpine, Alpine Biosciences, ALX Therapeutics, Apexian, Arcus Bio, Arcus Biosciences, Artios, Asana, Ascentage, Astellas, Aulos, Beigene, Biontech, Bristol Myers, Bristol Myers/Celgene, Celgene, Cerulean, Constellation, CytomX, Day One Bio, Formation Biologics, forbius, Forty Seven, Gilead, GSK, Helsinn, Ikena, Incyte, InhibRx, Innovent Biologics, Jounce, KSQ Therapeutics/Roche, Lilly, Livzon, Loxo/Lilly, Macrogenics, Merck, Mersana, Northern Biologics, Odonate, other from Janssen, other from Revolution Medicines, Pfizer, Pharma/Morphosys, Quanta Therapeutics, Regeneron, Repare Therapeutics, Samumed, Sapience, Seagen/Pfizer, Servier Therapeutics, SK Life Sciences, Symphogen, Tizona and Circle Pharma, Volastra. SB received institutional research funding from Shattuck Labs for this study. She also reports institutional research funding from AstraZeneca and GSK, and honoraria for consulting or serving in an advisory role for AbbVie, AstraZeneca, Beigene, Biontech, Eisai, Epsilogen, Gilead, GlaxoSmithKline, Genmab, Grey Wolf Therapeutics, Immunogen, Incyte, ITM Oncologics, Lilly, Merck Sharpe Dohme, Mersana, Myriad, Oncxerna, Pharma&, Seagen, Takeda, TORL BioTherapeutics, Verastem, Zai Laboratories, Zymeworks. DM received institutional research funding from Shattuck Labs for this study. She also reports institutional research funding from Merck, PinotBio, Eisai, and Acrivon. She has consulted or served in an advisory role for CVS Health, Eisai, GSK. AMO (Amit Oza) received institutional research funding from Shattuck Labs for this study. He also reports institutional research funding from AbbVie, Amgen and AstraZeneca. He also reports honoraria for consulting or serving in an advisory role for AstraZeneca (Steering Committee), BMS- Oncology Tumor Advisory Council, GlaxoSmithKline (Steering Committee), Immunogen, Senhwa Biosciences, Sutro Biopharma, Verastem Oncology (Steering Committee). RM received institutional research funding from Shattuck Labs for this study. She also reported receiving honoraria for serving on advisory boards for AbbVie, AstraZeneca, Clovis Oncology, Eisai, Ellipses, GSK, MSD, and Pharma&. DY received institutional research funding from Shattuck for this study. MPBG received institutional research funding from Shattuck Labs for this study. She also reports honoraria from AbbVie, AstraZeneca, Eisai, Genmab, GSK, MSD, Pharma&, Regeneron for serving on advisory boards and for attending meetings. JMG received institutional research funding from Shattuck Labs for this study. He also reports honoraria for educational events from GSK, AstraZeneca, PHARMA and Novartis. GW is a former employee and stockholder of Shattuck Labs. JM is an employee and stockholder of Shattuck Labs. AF is an employee and stockholder of Shattuck Labs. EG is an employee of Pivotal CRO and was the contract medical monitor for the study. LP is an employee and stockholder of Shattuck Labs. DR reports institutional research funding from Shattuck Labs for this study. She also reports honoraria for consulting or for serving on advisory boards for Araris, AstraZeneca, Corcept, Daiichi Sankyo, Eisai, Genmab, Genelux, GSK, Incyclix bio, Mersana, and Repare Therapeutics. She reports institutional Research funding from A2A Pharmaceuticals, Aadi, AbbVie, Allorian, AstraZeneca, Blueprint medicines, Daiichi Sankyo, Duality Bio, Genmab, GSK, Immunogen, Karyopharm, Mersana, Nimbus therapeutics, Nurix therapeutics, Oncusp therapeutics, PMV pharmaceuticals, Syros, Totus, Tubulis, Xencor, and Zentalis.

: This trial was conducted in full conformity with the Declaration of Helsinki and was approved by all Institutional Review Boards/ethics committees from each clinical site participating in the trial. All patients provided written informed consent in accordance with ICH/GCP guidelines and applicable local regulations prior to trial initiation. Ethics approval: This study involves human participants. This study was conducted between 27-Sep 2022 and 31-Dec 2024, at 21 locations in Canada, United States, United Kingdom, and Spain in full conformity with the Declaration of Helsinki and was approved by all Institutional Review Boards/ethics committees (IRB/EC) from each clinical site participating in the study. All patients provided written informed consent in accordance with ICH/GCP guidelines and applicable local regulations prior to study initiation. The following is a list of the IRB/EC that approved the study: Advarra IRB (study number Pro00064445; University of Oklahoma and Northwestern University); Salus IRB (STMW2021.74; START Mid-West); WCG (study number 1336957; City of Hope); University of Arkansas IRB (study number 274809); University of British Columbia Ethics Board (study number H22-01821); McGill University Health Center Research Ethics Board (study number 2023-9103); University Health Network Research Ethics Board (study number 22-5652); COMITÉ DE ÉTICA DE LA INVESTIGACIÓN CON MEDICAMENTOS Regional de la Comunidad de Madrid (study number 2022-000698-17; Instituto Catalan de Oncologia; Instituto Quiron Dexeus; START Fundacion Jimenez Diaz; Hospital Universitari Germans Trias I Pujol; Hospital Clinic de Barcelona; Hospital Vall d’Hebron; Hospital Universitario Virgen de la Arrixaca), and South Central Oxford B Research Ethics Committee (study number 1006068; The Royal Marsden NHS Foundation Trust; Guy’s & St. Thomas’ NHS Foundation Trust; University College London Hospital NHS Foundation Trust; The Christie NHS Foundation Trust; The Royal Marsden NHS Foundation Trust).