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Updated: May 16, 2026
09:12
High-Throughput Automated Multiplex Immunofluorescence Assays for Translational Research
Published on: June 10, 2025
Translating Innovation Into Practice: Dissemination of Immune Checkpoint Inhibitors and Their Toxicity Management
Mehak Trikha1, Susan Dent2, Kaysia Ludford3
1Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Summary
Optimizing immune checkpoint inhibitor (ICI) dosing and duration can maintain cancer treatment effectiveness while reducing costs and toxicities, especially in resource-limited settings. These pragmatic strategies improve immunotherapy accessibility and scalability globally.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacokinetics/Pharmacodynamics
Background:
- Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, offering durable responses.
- Widespread use presents challenges in cost, dosing, duration, and immune-related toxicities, particularly in low- and middle-income countries (LMICs).
Purpose of the Study:
- To review exposure optimization strategies for ICIs.
- To explore how these strategies address cost, feasibility, and toxicity challenges.
- To discuss the implications for both LMICs and high-resource settings.
Main Methods:
- Review of pharmacokinetic and pharmacodynamic data on PD-1 receptor occupancy.
- Analysis of clinical evidence from randomized trials and real-world studies.
- Examination of immune-related adverse events (irAEs), focusing on cardiovascular and gastrointestinal toxicities.
Main Results:
- Lower ICI doses and extended intervals can achieve near-maximal PD-1 occupancy, potentially preserving efficacy.
- LMIC-driven adaptations in delivery, toxicity management, and health systems offer practical insights.
- Optimized exposure strategies impact toxicity burden, necessitating careful management of irAEs.
Conclusions:
- Exposure optimization strategies can enhance the affordability and feasibility of cancer immunotherapy.
- These adaptations improve the scalability of ICIs, balancing efficacy, safety, and cost across diverse healthcare settings.
- Insights from LMICs can inform sustainable immunotherapy practices globally.
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