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gavocabtagene autoleucel + nivolumab is a combination of two distinct immunotherapies under clinical investigation for mesothelin-expressing solid tumors, including malignant pleural/peritoneal mesothelioma, ovarian cancer, non-small cell lung cancer, and cholangiocarcinoma. Gavocabtagene autoleucel is an autologous cell therapy product in which patients' T cells are genetically engineered using a lentiviral vector to express a T cell receptor fusion construct (TRuC) comprising a single-domain anti-mesothelin antibody linked to the CD3ε subunit. This enables direct recognition and killing of mesothelin-expressing cancer cells in an HLA-independent manner, resulting in robust anti-tumor T cell responses and tumor infiltration[1][3][5][6][7][8]. Nivolumab is a monoclonal antibody that targets programmed cell death protein 1 (PD-1), blocking its interaction with PD-L1 and PD-L2 to relieve inhibition of T cell activity and enhance anti-tumor immune responses[1][9]. The rationale for their combination is based on evidence that TRuC T cells show increased PD-1 expression after infusion, and the tumor microenvironment upregulates PD-L1 after TRuC therapy, suggesting potential benefit from simultaneous immune checkpoint blockade[1]. At the time of writing, the combination is being evaluated in phase 2 trials for safety and clinical efficacy.
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