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Nivolumab + temozolomide is an investigational combination therapy consisting of nivolumab, a monoclonal antibody immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1), and temozolomide, an oral alkylating agent that induces DNA damage in tumor cells. Nivolumab enhances anti-tumor immune responses by blocking the PD-1 pathway, thereby preventing T-cell inactivation. Temozolomide exerts cytotoxic effects by methylating DNA at the O6 and N7 positions of guanine, leading to apoptosis in rapidly dividing tumor cells. The combination is being studied for synergistic effects where chemotherapy may sensitize tumors to immunotherapy. This regimen has been evaluated primarily in advanced neuroendocrine neoplasms (NEN), glioblastoma, melanoma refractory to standard treatments, and small cell lung cancer (SCLC)[1][2][3][4].
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