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**Atezolizumab + emactuzumab** is an investigational combination therapy composed of two monoclonal antibodies: atezolizumab, a humanized IgG1 antibody targeting programmed death-ligand 1 (PD-L1), and emactuzumab, a humanized IgG1 antibody targeting colony-stimulating factor-1 receptor (CSF-1R). Atezolizumab acts as a checkpoint inhibitor by blocking PD-L1, thereby preventing its interaction with PD-1 and B7-1, which restores anti-tumor T-cell activity and immune surveillance. Emactuzumab blocks CSF-1R on tumor-associated macrophages, depleting immunosuppressive macrophages from the tumor microenvironment and potentially augmenting T-cell mediated anti-tumor immunity. This combination has been evaluated in phase 1b clinical trials for advanced solid tumors, including non-small cell lung cancer (NSCLC), urothelial bladder cancer (UBC), and melanoma, predominantly in patients who are either naïve or pretreated with immune checkpoint blockers. The combination demonstrated a manageable safety profile, with the most common adverse events being fatigue and rash, and increased activated CD8+ tumor-infiltrating lymphocytes associated with clinical benefit in some populations[1][3][5].
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