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**Pexastimogene devacirepvec + nivolumab** is a combination investigational therapy that includes pexastimogene devacirepvec (Pexa-Vec), an oncolytic vaccinia virus engineered to selectively target and lyse tumor cells, and nivolumab, a monoclonal antibody acting as a programmed death-1 (PD-1) immune checkpoint inhibitor. Pexa-Vec infects and replicates within tumor cells, inducing direct tumor lysis and expressing granulocyte-macrophage colony-stimulating factor (GM-CSF) to enhance systemic antitumor immunity, while nivolumab promotes T cell-mediated immune responses against tumors by blocking the inhibitory PD-1 receptor on T lymphocytes. This combination aims to synergistically activate immune responses and offer improved antitumor efficacy compared to monotherapy. The primary indication under clinical investigation is advanced liver cancer (hepatocellular carcinoma), with active clinical trials assessing the safety and efficacy of this regimen in solid tumors[1][7].
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