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A combination therapy consisting of **MTL-CEBPA**, a small activating RNA (saRNA) therapy that selectively upregulates the transcription factor CCAAT/enhancer-binding protein alpha (C/EBP-α), and **pembrolizumab**, a monoclonal antibody immune checkpoint inhibitor targeting PD-1. MTL-CEBPA is designed to relieve myeloid-driven immunosuppression in the tumor microenvironment (TME) by inducing differentiation of immature immunosuppressive myeloid cells, notably myeloid-derived suppressor cells (MDSCs), thus decreasing their immunosuppressive activity. Pembrolizumab blocks the interaction between PD-1 and its ligands (PD-L1/PD-L2), preventing T-cell inactivation. The combination aims to convert immunologically "cold" tumors, which are resistant to immunotherapy, into "hot" tumors with increased T-cell infiltration and enhanced anti-tumor response. Early clinical studies have focused on patients with advanced solid tumors showing resistance to immune checkpoint inhibitors.
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