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This is a combination of six immune checkpoint inhibitor monoclonal antibodies targeting the PD‑1/PD‑L1 pathway: camrelizumab, durvalumab, nivolumab, pembrolizumab, sintilimab, and tislelizumab. All are human or humanized IgG4 monoclonal antibodies that block either programmed cell death protein 1 (PD‑1) or its ligand PD‑L1 on tumor cells and immune cells. By inhibiting this pathway, these drugs enhance T-cell mediated anti-tumor immunity. Each agent is approved individually for various cancers including non-small cell lung cancer, melanoma, hepatocellular carcinoma, gastric cancer, esophageal squamous cell carcinoma and others[5][6][7][9][10]. There is no evidence that all six are used together clinically; this combination represents the full set of major anti-PD‑(L)1 agents currently in use.
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