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**Vidutolimod + nivolumab** is a combination investigational immunotherapy for cancer. Vidutolimod is a synthetic DNA-based agonist targeting the Toll-Like Receptor 9 (TLR9), designed to activate plasmacytoid dendritic cells and stimulate innate and adaptive anti-tumor immunity. Nivolumab is a fully human monoclonal antibody (brand name: Opdivo) that blocks the PD-1 receptor on T cells, thus preventing immune evasion by tumor cells via the PD-1/PD-L1 axis. In neoadjuvant clinical trials, particularly for high-risk, resectable stage III cutaneous melanoma, this combination has demonstrated robust anti-tumor immune responses, including a 55% major pathologic response rate. Mechanistically, their synergy is attributed to enhanced infiltration and activation of myeloid cells, plasmacytoid dendritic cells, and CD8+ tumor-infiltrating lymphocytes, setting this combination apart from nivolumab monotherapy. Vidutolimod is not FDA-approved and remains investigational; nivolumab is FDA-approved for various cancers.
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