cyclophosphamide + epirubicin + nivolumab

This is a combination regimen consisting of three agents: - Cyclophosphamide, an alkylating agent that crosslinks DNA, leading to cell death and immunomodulation. - Epirubicin, an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, resulting in cytotoxicity. - Nivolumab, a monoclonal antibody immune checkpoint inhibitor targeting the programmed death-1 (PD-1) receptor on T cells. By blocking PD-1 interaction with its ligands (PD-L1/PD-L2), nivolumab enhances T-cell mediated anti-tumor immunity[7][10]. This combination is being investigated primarily for use in cancer therapy—most notably breast cancer—in clinical trials. The rationale is to combine the cytotoxic effects of chemotherapy (cyclophosphamide and epirubicin) with the immunostimulatory effect of immune checkpoint blockade by nivolumab[9]. The approach aims to both directly kill tumor cells and enhance anti-tumor immune responses.