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Toripalimab + etoposide is an investigational combination therapy consisting of the PD-1 inhibitor toripalimab and the cytotoxic chemotherapy agent etoposide. Toripalimab is a humanized IgG4 monoclonal antibody that blocks the interaction between PD-1 on T cells and its ligands (PD-L1 and PD-L2), thereby restoring anti-tumor immune activity. Etoposide is a small molecule inhibitor of topoisomerase II, which induces DNA double-strand breaks and leads to cell cycle arrest and apoptosis. This combination is being evaluated, often in a metronomic dosing schedule, for the second-line treatment of extensive-stage small cell lung cancer (ES-SCLC). The metronomic approach involves low, continuous dosing of etoposide to provide sustained cytotoxic activity while potentially enhancing the immunomodulatory effects of the checkpoint inhibitor.
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