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This combination therapy regimen consists of ADI-PEG 20 (pegylated arginine deiminase), atezolizumab (a PD-L1 inhibitor), pemetrexed (an antifolate), and carboplatin (a platinum-based chemotherapeutic). It is being investigated by Queen Mary University of London in the iTRAP Phase I clinical trial for the treatment of advanced non-squamous non-small cell lung carcinoma (NSCLC), specifically targeting tumors that are deficient in argininosuccinate synthetase (ASS1). ADI-PEG 20 works by depleting systemic arginine, thereby starving ASS1-deficient tumor cells that cannot synthesize their own arginine. The addition of atezolizumab provides immune checkpoint inhibition, while pemetrexed and carboplatin serve as standard-of-care chemotherapy to enhance tumor cell death.
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