Cancer Immune Checkpoint Inhibitors

Speaker: Dr. Kerry Reynolds, Clinical Director of Inpatient Oncology at Massachusetts General Hospital.
Topic: Overview and mechanism of action of cancer immune checkpoint inhibitors.

Immune System Basics: The immune system uses T cells to recognize harmful antigens presented by antigen-presenting cells. This recognition is facilitated through a two-signal process involving various molecules and receptors.
Checkpoint Inhibitors: To prevent overactivation of the immune system, there are "checkpoints" that slow down the immune response. Cancer cells can misuse these checkpoints to avoid being targeted by the immune system.
Targeting Checkpoints: Immune checkpoint inhibitors are drugs designed to target these checkpoints, preventing cancer cells from hiding from the immune system and allowing the immune system to target the cancer cells more effectively.

Revolutionary Effect: These inhibitors have revolutionized cancer treatment, significantly improving survival rates for patients with metastatic diseases.
FDA Approvals: Since the first approval in 2011, there are now nine FDA-approved immune checkpoint inhibitors for over 17 types of cancer, with over 83 specific approved uses.

Development: Researchers are now developing combination therapies, which use checkpoint inhibitors alongside other treatments like chemotherapy or targeted therapy.
Benefits: These combinations have shown to be more effective in treating various types of cancer, marking a significant step forward in cancer treatment.

Expansion to Early Line Therapies: Initially used in metastatic diseases, these inhibitors are now being used in earlier stages of various cancers, expanding their applicability and potentially improving outcomes for patients.
Approvals for Early Use: As of 2021, these inhibitors have received approvals for early use in several types of cancer, including melanoma and lung cancer.

Clinical Trials: Over 2,000 clinical trials are underway to further explore the potential of these inhibitors in cancer treatment.
Adverse Events: Despite the promising results, between 10% to 30% of patients experience serious immune-related adverse events, highlighting a need for careful management and further research to mitigate these effects.

Positive Impact: Immune checkpoint inhibitors have become a standard of care in oncology, offering long-term responses and improved survival rates for many patients.
Next Steps: The medical community is working to bring these therapies to earlier lines of treatment, aiming to further improve outcomes for cancer patients.