[Immuno-oncology--silver bullets or mass destruction weapons?]

Modes of treatment affecting the regulatory mechanisms of cell-mediated immunity are changing the treatment practices of various types of cancer. Antibodies inhibiting regulatory molecules of the immune response, i.e. checkpoint inhibitors, are of particular interest. The mechanism of action is enhancement of the body's intrinsic responses to cancer cells through inhibition of negative regulation of the immune defense. Cell-mediated immunity directed to cancerous tissue can be enhanced by removing the brake associated with T-cell activation (CTLA-4 inhibitors). A more physiological mode of action is to abolish the attenuation mechanism of already activated T cells (PD-1 inhibitors). The physiological purpose of both mechanisms is to prevent an excessively strong immune reaction and thus autoimmunity.