atezolizumab + pemetrexed

Atezolizumab + pemetrexed is a combination therapy used primarily in the treatment of non-small cell lung cancer (NSCLC). This combination pairs atezolizumab, a PD-L1 inhibitor immunotherapy, with pemetrexed, an antifolate chemotherapy agent. Atezolizumab works by blocking the interaction between PD-L1 and PD-1, preventing immunosuppression and restoring T-cell anti-tumor activity. Pemetrexed disrupts folate metabolism and DNA synthesis by blocking enzymes involved in these processes, interfering with cell division. Research suggests pemetrexed may enhance immunotherapy response by upregulating PD-L1 expression through the thymidylate synthase (TS)-reactive oxygen species (ROS)-NF-κB regulatory axis, potentially creating a more favorable tumor microenvironment for immune checkpoint blockade.