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This combination therapy consists of envafolimab, a subcutaneously administered PD-L1 inhibitor, paired with the standard-of-care 'AI' chemotherapy regimen, which includes doxorubicin and ifosfamide. Envafolimab is a unique single-domain antibody-Fc fusion protein targeting the programmed death-ligand 1 (PD-L1) to enhance anti-tumor immune responses. Doxorubicin is an anthracycline that intercalates DNA and inhibits topoisomerase II, while ifosfamide is an alkylating agent that cross-links DNA. The combination is being investigated by the Second Affiliated Hospital, School of Medicine, Zhejiang University as a first-line treatment for advanced soft tissue sarcoma. This approach leverages the potential of anthracyclines to induce immunogenic cell death and upregulate PD-L1 expression, thereby potentially sensitizing the tumor to checkpoint inhibition and improving clinical outcomes in a highly heterogeneous malignancy.
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