Immune checkpoint inhibitors

Immunology-based therapy is rapidly developing into an effective treatment option for a surprising range of cancers. We have learned over the last decade that powerful immunologic effector cells may be blocked by inhibitory regulatory pathways controlled by specific molecules often called "immune checkpoints." The development of a new therapeutic class of drugs that inhibit these inhibitory pathways has recently emerged as a potent strategy in oncology. Three sets of agents have emerged in clinical trials exploiting this strategy. These agents are antibody-based therapies targeting cytotoxic T-lymphocyte antigen 4 (CTLA4), programmed cell death 1 (PD-1), and programmed cell death ligand 1 (PD-L1). These inhibitors of immune inhibition have demonstrated extensive activity as single agents and in combinations. Clinical responses have been seen in melanoma, renal cell carcinoma, small cell lung cancer, and several other tumor types.

 One of the most exciting aspects of checkpoint inhibition in cancer therapy is that, unlike conventional cytotoxic drugs and targeted agents, it has the potential to work universally in all cancers. Checkpoint inhibitors, alone or in combination, have yielded promising results not only in advanced melanoma and RCC but also in triple-negative breast cancer and cancers of the prostate, bladder, lung, and head and neck.

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