The TWINPEAK trial (NCT05482893) has dosed its first patient, evaluating PT886 combined with pembrolizumab for gastric and GEJ cancers. PT886 targets claudin 18.2 and CD47 to enhance immune response. The study is a multicenter, open-label, phase 1/2 trial assessing safety, tolerability, and efficacy in advanced gastric, GEJ, and pancreatic cancers. PT886 has FDA orphan drug designation for pancreatic cancer and fast track designation for metastatic claudin 18.2-positive pancreatic adenocarcinoma.