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**Tirapazamine + nivolumab** is an experimental combination of a bioreductive small molecule cytotoxic agent and an anti-PD-1 monoclonal antibody. Tirapazamine is selectively activated under hypoxic conditions commonly found in solid tumors, where it produces reactive species that damage DNA, leading to cancer cell death. Nivolumab is a human IgG4 monoclonal antibody that binds to the programmed death 1 (PD-1) receptor on T cells, blocking its interaction with PD-L1 and PD-L2, thereby releasing the inhibition of the immune response against tumor cells. This combination aims to exploit both the direct DNA-damaging effects of tirapazamine and the immune-activating properties of nivolumab. The primary indications in clinical study have been various solid tumors, though no routine or regulatory-approved use for this combination has been established.
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