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This combination therapy consists of pembrolizumab, a humanized monoclonal IgG4-kappa antibody targeting the programmed cell death protein 1 (PD-1) receptor, and asparaginase, an enzyme that catalyzes the hydrolysis of asparagine. Investigated by Chang Gung Memorial Hospital, this regimen is specifically evaluated for patients with locoregionally advanced or recurrent-metastatic nasopharyngeal carcinoma (NPC) who have progressed on prior immune checkpoint blockade. The rationale for the combination is that asparaginase may enhance the efficacy of PD-1 inhibition by improving CD8+ T cell fitness and overcoming resistance to immunotherapy. In clinical studies, patients received sequential asparaginase followed by pembrolizumab as a form of compassionate therapy for advanced disease.
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