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CRS-207 + epacadostat + pembrolizumab is an investigational triple combination cancer immunotherapy regimen. CRS-207 is a live-attenuated, double-deleted *Listeria monocytogenes* engineered to express human mesothelin, designed to induce mesothelin-specific T-cell responses and modulate the tumor microenvironment[1][3][7]. Pembrolizumab is a monoclonal antibody blocking the programmed death-1 (PD-1) receptor on T cells, thereby enhancing antitumor immune responses[2][6]. Epacadostat is a small molecule inhibitor of indoleamine 2,3-dioxygenase 1 (IDO1), which reduces immunosuppressive tryptophan catabolism in the tumor microenvironment (not directly mentioned in results but well-established in literature for epacadostat). The combination is being studied mainly in solid tumors to synergistically enhance antitumor immunity by: 1) priming T cell responses (CRS-207), 2) reversing immune checkpoints (pembrolizumab), and 3) overcoming IDO1-mediated immune suppression (epacadostat). This regimen has been investigated primarily in advanced cancers including malignant pleural mesothelioma, ovarian cancer, and pancreatic cancer[1][3].
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