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MTG201 + nivolumab is an investigational combination therapy being evaluated for the treatment of relapsed malignant pleural mesothelioma. The regimen combines two agents: - **MTG201** is a novel gene therapy based on a replication-incompetent adenoviral vector encoding the Reduced Expression in Immortalized Cells/Dickkopf-3 (REIC/Dkk-3) gene. In cancer cells, REIC/Dkk-3 expression is typically downregulated; restoring its expression via intratumoral injection triggers immunogenic cell death selectively in tumor cells and enhances anti-tumor immunity by activating dendritic cells and natural killer (NK) cells while suppressing regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). - **Nivolumab** is a monoclonal antibody immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1), blocking its interaction with ligands to restore T-cell mediated anti-tumor responses. Preclinical studies have shown that this combination produces synergistic anti-tumor effects. The Phase 2 clinical trial involves intratumoral administration of MTG201 alongside intravenous nivolumab in patients who have failed first-line cisplatin-based chemotherapy[1][2][3][4][5].
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