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Pegzilarginase + pembrolizumab is a combination investigational therapy comprised of **pegzilarginase**, a recombinant, cobalt-substituted and pegylated human arginase 1 enzyme, and **pembrolizumab**, an anti–programmed death-1 (PD-1) monoclonal antibody. Pegzilarginase acts by depleting plasma arginine, which in turn may reduce toxic metabolites in conditions like arginase 1 deficiency and create metabolic stress in tumors that are arginine-dependent[1][5]. Pembrolizumab blocks the PD-1 receptor on T cells, thereby potentiating anti-tumor immune responses[2][4]. The combination is being evaluated for synergistic efficacy in cancer, leveraging pegzilarginase-induced metabolic modulation to enhance T-cell activity and potentially improve pembrolizumab-mediated immunotherapy response[3]. The main developer for pegzilarginase is **Immedica**[1]. Pembrolizumab is developed and manufactured by **Merck**.
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