Nivolumab is a fully human, monoclonal IgG4 antibody that binds to programmed death-1 (PD-1) receptors with high specificity and affinity. PD-1 is expressed on T cells and dampens their immune response upon binding ligands PD-L1 and PD-L2 on APCs. This mechanism is pivotal to regulating central and peripheral tolerance. In cancer, aberrant PD-L1 expression by tumor cells or immune cells in the tumor microenvironment deactivates PD-1, expressing tumor-infiltrating lymphocytes, thereby allowing tumor cells to escape immune recognition and elimination. By inhibiting PD-1 function, nivolumab releases immune cells from pathological immune suppression, allowing them to recognize and counter tumor cells.
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