epacadostat + pembrolizumab + cisplatin + pemetrexed

A **combination regimen** of epacadostat (an oral inhibitor of indoleamine 2,3-dioxygenase 1), pembrolizumab (an intravenous programmed death protein 1 [PD-1] inhibitor), cisplatin (a platinum-based cytotoxic chemotherapy), and pemetrexed (an antifolate cytotoxic chemotherapy), designed as a multifactorial treatment for advanced solid tumors, especially non–small cell lung cancer (NSCLC). **Epacadostat** inhibits IDO1, preventing immunosuppression in the tumor microenvironment and contributing to immune activation[2]. **Pembrolizumab** blocks PD-1, reactivating T-cells against cancer[2]. **Cisplatin** induces DNA crosslinking, causing cell death. **Pemetrexed** disrupts folate-dependent pathways, leading to cell cycle arrest and apoptosis. Trials involving epacadostat + pembrolizumab have demonstrated tolerability but limited clinical benefit in NSCLC and other advanced malignancies, and investigations into quadruple therapy (including cisplatin plus pemetrexed) are exploratory and generally at early or investigational phases[1][2]. This regimen targets both immune checkpoints and proliferative cancer pathways.

Brand names

Keytruda (pembrolizumab)Alimta (pemetrexed)none for epacadostat (investigational name)none for cisplatin (generic name)