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VSSP (very small size particles) is a nanoparticulated immunomodulatory drug composed of outer membrane vesicles from the gram-negative bacterium *Neisseria meningitidis* and the GM3 ganglioside. It acts as a Toll-like receptor 2/Toll-like receptor 4 agonist, facilitating maturation and activation of dendritic cells, promoting Th1 polarization, enhancing antigen-specific cytotoxic T lymphocyte responses, and abrogating the suppressive activity of myeloid-derived suppressor cells by inducing their differentiation into stimulatory antigen-presenting cells. VSSP also polarizes macrophages to an M1 phenotype with tumoricidal activity and has demonstrated anti-tumor effects in various preclinical models. It is being developed primarily for use as an immunotherapy or adjuvant in cancer treatment, including prostate cancer and ovarian cancer. Four vaccine formulations containing VSSP are currently in clinical trial stages for different solid tumors[2][3].
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