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Nivolumab and pembrolizumab are both fully human IgG4 monoclonal antibodies that target the Programmed Death-1 (PD-1) receptor. By binding to PD-1, these agents block the interaction with its ligands, PD-L1 and PD-L2, thereby inhibiting the immune checkpoint pathway that tumors use to evade the immune system. This blockade restores the activity of anti-tumor T-cells. In the context of clinical trial NCT04114136, these two anti-PD-1 therapies are used as the standard-of-care backbone to evaluate the efficacy of adding metabolic modulators like metformin or rosiglitazone in patients with various advanced solid tumors, including melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma. The choice between the two agents is typically determined by the approved indication for the patient's specific disease or at the investigator's discretion.
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