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The PRaG2.0 regimen is an experimental combination immunotherapy protocol developed by the Second Affiliated Hospital of Soochow University for the treatment of advanced, refractory solid tumors, particularly those that have developed resistance to prior PD-1/PD-L1 checkpoint inhibitor therapy. The regimen consists of a PD-1 or PD-L1 inhibitor (rechallenge) administered in combination with hypofractionated radiotherapy, granulocyte-macrophage colony-stimulating factor (GM-CSF), and interleukin-2 (IL-2). This multi-modal approach is designed to overcome immune resistance by utilizing radiotherapy to induce immunogenic cell death and release tumor-associated antigens (the abscopal effect), while GM-CSF and IL-2 act as systemic adjuvants to enhance dendritic cell recruitment and T-cell proliferation. By combining these elements, the regimen aims to convert immunologically "cold" tumors into "hot" tumors and restore the efficacy of checkpoint blockade therapy.
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