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This investigational combination therapy, being studied by the University of California, Irvine, pairs the PD-1 inhibitor pembrolizumab with metronomic (low-dose, continuous) oral cyclophosphamide. It is specifically targeted at adult patients with unresectable Stage III or IV melanoma who have progressed on prior treatment with PD-1 or PD-L1 checkpoint inhibitors. The therapeutic rationale relies on the ability of metronomic cyclophosphamide to selectively deplete regulatory T cells (Tregs) and stimulate an anti-tumor immune response, potentially sensitizing refractory tumors to the checkpoint blockade provided by pembrolizumab.
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