Dosing immune-checkpoint inhibitors: Opportunities for the future

Area of Science:

• Oncology
• Immunotherapy
• Pharmacology

Background:

• Recent advances in immunotherapy have led to immune checkpoint inhibitors (ICIs) for cancer treatment.
• Despite breakthroughs, ICIs offer modest survival benefits and carry risks of toxicity and resistance.
• Current dosing and intervals limit patient access, especially in resource-limited settings.

Purpose of the Study:

• To review current literature on model-based and clinical studies of ICIs.
• To discuss strategies for enhancing access and utilization of ICIs.
• To address limitations in current ICI dosing and identify areas for practice change.

Main Methods:

• Review of existing model-based and clinical studies on immune checkpoint inhibitors.
• Analysis of current dosing strategies, including fixed vs. weight-based dosing.
• Exploration of biomarker development and alternative clinical trial designs.

Main Results:

• Modest survival benefits and potential for increased toxicity with ICIs.
• Significant access barriers due to high costs and fixed dosing schedules.
• Evidence supporting personalized approaches, including dose adjustments and biomarkers.

Conclusions:

• Optimizing ICI dosing and intervals is crucial for improving patient access and outcomes.
• Personalized medicine strategies, including biomarkers, can enhance ICI efficacy and reduce toxicity.
• Further research and alternative trial designs are needed to expand ICI utilization globally.