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Gemcitabine + nivolumab is a combination regimen of two anticancer agents used primarily in the treatment of advanced or metastatic cancers, most notably urothelial carcinoma. Gemcitabine is a nucleoside analog that inhibits DNA synthesis, leading to cell death in rapidly dividing tumor cells. Nivolumab is a monoclonal antibody immune checkpoint inhibitor targeting programmed death-1 (PD-1) on T cells, blocking its interaction with PD-L1 and PD-L2 ligands on tumor cells and thereby enhancing the immune system's ability to recognize and destroy cancer cells. This combination leverages both direct cytotoxic effects from gemcitabine and immunomodulatory effects from nivolumab, aiming for synergistic antitumor activity. The regimen has been studied as part of multi-drug protocols (often with cisplatin), but maintenance therapy with just gemcitabine + nivolumab has also been explored following initial disease control[6][10].
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