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Immunotherapy Combined or Sequenced With Targeted Therapy in the Treatment of Solid Tumors: Current Perspectives
Michael B Atkins1, James Larkin2
1Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (MBA); Royal Marsden Hospital, London, UK (JL). mba41@georgetown.edu.
Abstract:
The advent of newer immunotherapeutic and molecularly targeted agents has provided a number of effective options for cancer treatment but has also added much complexity in selecting the best initial treatment or treatment plan for each patient. Molecularly targeted agents offer selectivity and are the cornerstone for "precision medicine." While targeted agents are associated with high tumor response rates, patients inevitably develop resistance to these drugs. Immunotherapies exploit the endogenous immune system to eradicate cancer and can produce durable disease control that results in long-term, treatment-free survival in some patients. Guidelines for treatment selection in patients with specific tumor types and clinical features are routinely being reconsidered in order to accommodate the increasingly complex treatment landscapes. Here, we review current perspectives on the use of immunotherapeutic agents, particularly immune checkpoint inhibitors (nivolumab, pembrolizumab, and ipilimumab), in combination or in sequence with molecularly targeted agents in patients with advanced melanoma as well as other tumor types. We further discuss remaining unmet needs for patient selection and treatment with approved therapies.
Insights
Newer cancer treatments like immunotherapy and molecularly targeted agents offer effective options but increase complexity. Combining these approaches, especially immune checkpoint inhibitors, shows promise for advanced melanoma and other cancers.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Cancer treatment landscape is evolving with novel immunotherapeutic and molecularly targeted agents.
- Precision medicine relies on molecularly targeted agents for selectivity, but resistance is a common challenge.
- Immunotherapies harness the immune system for durable cancer control and potential long-term remission.
Purpose of the Study:
- To review current perspectives on combining immunotherapy and molecularly targeted agents.
- To discuss the use of immune checkpoint inhibitors (nivolumab, pembrolizumab, ipilimumab) in advanced melanoma and other cancers.
- To identify unmet needs in patient selection and treatment strategies.
Main Methods:
- Review of current literature on immunotherapeutic and molecularly targeted agents.
- Analysis of treatment strategies involving combinations or sequences of these agents.
- Discussion of clinical data for advanced melanoma and other tumor types.
Main Results:
- Immunotherapy and targeted agents offer distinct mechanisms for cancer eradication.
- Combinations or sequences of these agents are being explored to overcome resistance and improve outcomes.
- Immune checkpoint inhibitors show efficacy in advanced melanoma and other malignancies.
Conclusions:
- The complex treatment landscape necessitates updated guidelines for optimal patient management.
- Further research is needed to address patient selection and refine treatment protocols for combination therapies.
- Understanding resistance mechanisms and optimizing sequencing are critical for maximizing therapeutic benefit.
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