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Pembrolizumab + epacadostat is a combination therapy investigated for the treatment of advanced or metastatic solid tumors, including melanoma, non-small cell lung cancer (NSCLC), renal cell carcinoma, endometrial adenocarcinoma, urothelial carcinoma, and squamous cell carcinoma of the head and neck. Pembrolizumab is a monoclonal antibody that targets the programmed cell death protein 1 receptor (PD-1) on T cells, blocking its interaction with PD-L1 and PD-L2 to enhance anti-tumor immune responses. Epacadostat is an orally administered small molecule inhibitor of indoleamine 2,3-dioxygenase 1 (IDO1), an enzyme involved in tryptophan metabolism that suppresses immune responses in the tumor microenvironment. By inhibiting IDO1, epacadostat aims to restore effector T cell function and synergize with checkpoint inhibition by pembrolizumab. The combination has shown antitumor activity in early-phase clinical trials but failed to demonstrate benefit over monotherapy in a large phase III trial for advanced melanoma[1][2][3][4][6].
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