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Published on: February 8, 2018
Challenges faced when identifying patients for combination immunotherapy
Marc S Ernstoff1, Shipra Gandhi1, Manu Pandey2
1Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
Abstract:
In 1996, Jim Allison demonstrated that blocking the immune regulatory molecule CTLA-4 with anit-CTLA4 antibody led to enhance tumor responses in mice. It would take an additional 15 years for human studies to confirm the potency and clinical efficacy of anti-CTLA4, ultimately leading to US FDA approval of the first checkpoint inhibitor, ipilimumab. Now with a plethora of immune-modulating agents demonstrating single agent safety and benefit across many tumor types, investigation on the optimal combination of immune-based therapies has begun in earnest. While there are many challenges, a central one is how to select which combination for which patient is the best. Here we review the current approaches that a practitioner can use to achieve this therapeutic goal.
Insights
Immune checkpoint inhibitors like anti-CTLA4 antibodies have revolutionized cancer treatment. Selecting the optimal combination therapy for each patient remains a key challenge in immuno-oncology.
Area of Science:
- Immunology
- Oncology
- Medical Science
Background:
- The discovery of CTLA-4 blockade in 1996 showed potential for enhancing anti-tumor responses in mice.
- Clinical validation of anti-CTLA4 antibodies, like ipilimumab, led to FDA approval and established checkpoint inhibitors in cancer therapy.
- Numerous immune-modulating agents are now available, prompting research into combination therapies.
Purpose of the Study:
- To review current strategies for selecting optimal combination immunotherapies.
- To address the challenge of personalized combination therapy selection in immuno-oncology.
Main Methods:
- Review of existing literature and clinical data on immune-modulating agents.
- Analysis of current approaches to combination therapy selection.
Main Results:
- Anti-CTLA4 antibodies have demonstrated significant clinical efficacy.
- The development of multiple immune checkpoint inhibitors has created opportunities for combination therapies.
- Identifying the best combination for individual patients is a complex but critical area of research.
Conclusions:
- Optimizing combination immunotherapy requires careful patient selection.
- Further research is needed to establish clear guidelines for combination therapy selection.
- Personalized approaches are essential for maximizing the benefits of immuno-oncology.
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