I will post it! That is an excellent question t

I will post it!

That is an excellent question that goes to the heart of the current research into leronlimab's potential mechanism of action in solid tumors, especially in combination with immune checkpoint inhibitors (ICIs).The core hypothesis, supported by recent clinical data in metastatic triple-negative breast cancer (mTNBC) and colorectal cancer, is that leronlimab acts as a "priming" agent by upregulating PD-L1 expression on tumor cells, specifically on the circulating tumor-associated cells (CTCs/CAMLs) captured by the Creatv Bio LifeTracDx test.1Here is a breakdown of how Leronlimab factors into the PD-L1 landscape:???? Leronlimab: The CCR5 Antagonist as a PD-L1 UpregulatorLeronlimab is a monoclonal antibody that blocks the C-C chemokine receptor type 5 (CCR5).2 The CCR5 receptor is expressed on various immune cells and is also overexpressed in many aggressive solid tumors (like TNBC, where it's found in ~95% of cases).3 The current data suggests that by blocking CCR5, leronlimab may achieve two critical effects:1. Conversion of "Cold" Tumors to "Hot" TumorsThe Problem: Many aggressive tumors, known as "cold" tumors, have low baseline PD-L1 expression and a poor immune-cell infiltration profile, making them resistant to PD-1/PD-L1 Immune Checkpoint Inhibitors (ICIs) like Keytruda.4The Proposed Leronlimab Solution (Mechanism): CCR5 signaling in cancer cells and the tumor microenvironment (TME) is associated with immune resistance.5 Research suggests that CCR5 expression suppresses glycosylated PD-L1.6 By inhibiting CCR5, leronlimab appears to reverse this suppression, leading to a significant increase in PD-L1 expression on the surface of circulating tumor-associated cells (CTCs and CAMLs).7Clinical Observation: In clinical analyses of mTNBC patients treated with leronlimab, a majority of patients (reported as high as 76% to 88% in different cohorts) showed a significant rise in PD-L1 expression on their circulating cells (measured via the LifeTracDx liquid biopsy) within 30-90 days of starting leronlimab.82. Enhancing Response to Immune Checkpoint Inhibitors (ICIs)The goal of ICIs is to block the PD-1/PD-L1 pathway, which tumors use to hide from T-cells. However, if a tumor expresses little or no PD-L1, the ICI has no target and is ineffective.By upholding PD-L1 via CCR5 blockade, leronlimab potentially "primes" the tumor environment, making the tumor cells visible to the immune system and creating the necessary target for subsequent or concurrent ICI therapy.9Survival Correlation: In the mTNBC pooled analysis, patients who demonstrated this leronlimab-induced PD-L1 upregulation and subsequently received an ICI showed promising long-term survival observations (some alive after 4+ years), strongly supporting the concept of leronlimab as an immunotherapy sensitizer.10???? The Role of the Creatv Bio Liquid BiopsyThis entire mechanism relies on the ability to detect and monitor the change in PD-L1 expression, which is where the Creatv Bio LifeTracDx liquid biopsy becomes indispensable:Baseline & Monitoring: The test provides a real-time, non-invasive assessment of PD-L1 expression on CTCs and CAMLs before leronlimab treatment, confirming if the tumor is initially "cold" (low PD-L1).11Confirmation of Priming: It allows for monitoring post-leronlimab treatment to confirm the upregulation of PD-L1.12 This is a crucial step in the proposed protocol to identify patients who have been successfully primed and are now candidates for an ICI.Surrogate for Tumor Tissue: Because the liquid biopsy captures actual tumor material (CTCs/CAMLs), it may provide a more accurate and comprehensive measure of the PD-L1 status across the patient's entire, heterogeneous tumor burden than a single tissue sample.In summary, the leronlimab/Creatv Bio synergy suggests a novel treatment paradigm:$$\text{CCR5+ Cancer} \xrightarrow{\text{Leronlimab (CCR5 Blockade)}} \text{PD-L1 Upregulation (Priming)} \xrightarrow{\text{ICI Therapy}} \text{Enhanced Anti-Tumor Response}