nivolumab + tadalafil + vancomycin

This is an investigational combination therapy consisting of three agents—nivolumab, tadalafil, and vancomycin—studied primarily in advanced hepatocellular carcinoma (HCC) and liver-dominant metastatic cancers from colorectal or pancreatic origin. Nivolumab is a monoclonal antibody immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1), enhancing T-cell mediated anti-tumor immunity. Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor that reduces myeloid-derived suppressor cells (MDSCs), thereby promoting anti-tumor immune responses. Oral vancomycin, a glycopeptide antibiotic, alters the gut microbiome by affecting bile acid-metabolizing bacteria; this leads to increased CXCL16 expression in the liver and enhances natural killer T cell-mediated anti-tumor effects. The rationale for combining these agents is to synergistically modulate the tumor microenvironment through immunomodulation and microbiome alteration alongside direct immune checkpoint inhibition[1][3][4][5][7].

Other names

nivolumab + tadalafil + oral vancomycin