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This is a combination of three immune checkpoint inhibitors (atezolizumab, nivolumab, and pembrolizumab) and two bone-targeting agents (denosumab and zoledronate). The immune checkpoint inhibitors work by blocking the PD-1/PD-L1 pathway to enhance T-cell immune responses against cancer cells. Denosumab is a RANKL inhibitor and zoledronate is a bisphosphonate, both used to prevent skeletal-related events in patients with bone metastases.
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