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Published on: February 5, 2020
Double Guard Efficiency and Safety-Overcoming Resistance to Immunotherapy by Blocking or Stimulating Several Immune
Ewa Kalinka1, Kamila Wojas-Krawczyk2, Paweł Krawczyk2
1Department of Oncology, Polish Mother's Memorial Hospital-Research Institute, 93-338 Łódź, Poland.
Abstract:
Immunotherapy is one of the leading systemic therapies in non-small cell cancer (NSCLC) patients, but it is not effective in an important proportion of them due to primary or secondary resistance mechanisms. Clinicians do not have the tools to predict immunotherapy resistance, and thus, many patients still fail initial treatment. One of the scientific concepts to avoid resistance and/or offer the patient effective salvage second-line treatment is the dual immunologic checkpoint blockade. We aimed to review published and available data on combination immunotherapy in terms of mechanisms, efficacy, and safety data on many different dual blockades. We discussed the potential of combined CTLA-4 (Cytotoxic T Lymphocyte Antigen 4), PD-1 (Programmed Death 1) or PD-L1, TIGIT, LAG-3, TIM-3, macrophage leukocyte immunoglobulin-like receptor B2 (LILRB2/ILT4), S15-mediated immune suppression (SIGLEC-15), CD137, ICOS, and OX40 inhibitors in NSCLC treatment.
Insights
Dual immunologic checkpoint blockade shows promise for overcoming resistance in non-small cell lung cancer (NSCLC) immunotherapy. This strategy combines inhibitors like CTLA-4 and PD-1 to improve treatment effectiveness for patients who don't respond initially.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Immunotherapy is a key treatment for non-small cell lung cancer (NSCLC).
- A significant number of NSCLC patients exhibit primary or secondary resistance to immunotherapy.
- Predictive tools for immunotherapy resistance are lacking, leading to treatment failures.
Purpose of the Study:
- To review existing data on combination immunotherapy strategies for NSCLC.
- To explore the mechanisms, efficacy, and safety of dual immunologic checkpoint blockade.
- To identify potential therapeutic targets for overcoming immunotherapy resistance.
Main Methods:
- Systematic review of published and available data on combination immunotherapies.
- Analysis of dual immunologic checkpoint blockade combinations.
- Discussion of various immune checkpoint inhibitors including CTLA-4, PD-1/PD-L1, TIGIT, LAG-3, TIM-3, LILRB2/ILT4, SIGLEC-15, CD137, ICOS, and OX40.
Main Results:
- Dual immunologic checkpoint blockade presents a scientific approach to circumvent resistance mechanisms.
- Combination therapies offer potential for effective salvage second-line treatment in NSCLC.
- The review encompasses a broad range of dual blockade combinations and their clinical implications.
Conclusions:
- Dual immunologic checkpoint blockade is a promising strategy to enhance immunotherapy efficacy in NSCLC.
- Further research into specific combinations is warranted to optimize patient outcomes.
- Addressing immunotherapy resistance through combination therapies is crucial for improving NSCLC treatment.
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