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Immunotherapy Drugs: Revolutionizing Cancer Treatment A Glimpse into the Future
Immunotherapy, also known as biological therapy, is an innovative approach that utilizes the body’s own immune system to fight cancer. By harnessing the power of the immune system, immunotherapy seeks to enable the body’s natural defenses to recognize and destroy cancer cells. Over the past decade, major advances have been made in immunotherapy research and a new class of drugs known as checkpoint inhibitors have revolutionized cancer treatment. Checkpoint inhibitors work by taking the brakes off immune cells called T cells, allowing them to more effectively target and eliminate cancerous growths. Clinical trials have shown these types of drugs can produce long-lasting remissions for some patients with cancers like melanoma, lung cancer, kidney cancer, and lymphoma. The success of checkpoint inhibitors has established immunotherapy as a fifth pillar of cancer treatment alongside surgery, chemotherapy, radiation therapy, and targeted therapy.
How Immunotherapy Works
The immune system naturally protects the body from disease by distinguishing healthy “self” cells from outside “non-self” invaders like bacteria and viruses. However, cancer cells can sometimes evade detection by altering the signals they send to immune cells. Immunotherapy seeks to counteract these evasive maneuvers employed by cancers. Checkpoint inhibitor drugs block inhibitory proteins called immune checkpoints that keep T cells from attacking other cells in the body, thus preventing autoimmune disease. However, some tumor cells upregulate these same immune checkpoint proteins to evade destruction by T cells. By blocking these checkpoints like PD-1 and CTLA-4, immunotherapy “takes the brakes off” T cells and enables them to recognize and eliminate cancer cells. Other immunotherapy approaches utilize engineered immune cells or immunotherapy vaccines to stimulate a more powerful antitumor response. By harnessing the precision of the immune system, immunotherapy seeks to provide targeted, long-lasting control of cancer with potentially fewer side effects than traditional therapies.
Types of Immunotherapy Drugs
Checkpoint Inhibitors
As mentioned, checkpoint inhibitors are a major class of Immunotherapy drugs that work by blocking inhibitory checkpoint proteins and releasing brakes on T cells. Some key checkpoint inhibitors approved for cancer treatment include:
— Pembrolizumab (Keytruda): Approved for lung cancer, melanoma, Hodgkin’s lymphoma, head and neck cancer, stomach cancer, cervical cancer, and others.
— Nivolumab (Opdivo): Approved for lung cancer, melanoma, Hodgkin’s lymphoma, kidney cancer, bladder cancer, head and neck cancer, and other tumors.
— Ipilimumab (Yervoy): The first checkpoint inhibitor approved, for melanoma.
— Atezolizumab (Tecentriq): Approved for bladder cancer, lung cancer and triple-negative breast cancer.
Adoptive Cell Transfer
This approach harvests immune cells called T cells from a patient’s tumor or blood and engineers them in the laboratory to target specific cancer antigens. The modified T cells are then infused back into the patient in large numbers to initiate an anti-tumor response. The first approved CAR T-cell therapy was tisagenlecleucel (Kymriah) for leukemia.
Immune Cell Therapies
Therapies made from cytokines and other immune system proteins activate immune cells in fighting cancer. Interferons and interleukins are immune cell therapies that have been approved for melanoma, kidney cancer, leukemia and other cancers.
Immune Checkpoint Pathways in Cancer Immunotherapy
As more checkpoint inhibitors are developed and approved, research is deepening understanding of immune checkpoint pathways. Many cancers appear to co-opt multiple checkpoint mechanisms to evade immune detection and destruction. This has spurred investigation into combination approaches that simultaneously target two or more checkpoints. Clinical trials are exploring double or triple blockade with drugs like pembrolizumab plus axitinib or avelumab for renal cell carcinoma, and nivolumab plus ipilimumab for melanoma and lung cancer.
Scientists are also shedding light on new checkpoint pathways in the tumor microenvironment beyond just PD-1 and CTLA-4. Pathways under study include VISTA, TIM-3, LAG-3, TIGIT, and others that are potential drug targets. By saturating multiple inhibitory checkpoints, it may be possible to more thoroughly “take the brakes off” T cells and achieve greater clinical benefits than single agent checkpoint therapy alone. Combination approaches may also help broaden the population of cancer patients who obtain durable responses from immunotherapy. Determining optimal combination regimens, sequencing, and predictive biomarkers remains an area of active investigation.
Challenges and Future Outlook
While immunotherapy has brought remarkable results for some patients, its benefits have primarily been seen for tumors with high mutational burdens that engender strong anti-tumor immune responses. Cancers like lung, melanoma, and bladder cancer tend to respond best. Implementation of immunotherapy has faced challenges for tumors with low mutational loads or those able to avoid immune recognition through other mechanisms. Strategies are underway to address these challenges, including combination approaches, vaccines, and personalized neoantigen therapy. By identifying each patient’s unique tumor mutations, it may be possible to design personalized vaccines or engineered T cells tailored for their cancer.
other ongoing research priorities include investigating biomarkers to predict which patients will benefit most from different immunotherapy regimens. Understanding factors influencing response or resistance will enable better patient selection and sequencing of immunotherapy drugs. New delivery methods are also needed to make cell-based immunotherapies like CAR T-cell therapy more widely available. Overcoming immunosuppressive factors in the tumor microenvironment through combination strategies remains an area of active investigation as well. With continued research, immunotherapy holds tremendous promise to transform cancer treatment and provide new hope to many patients worldwide.
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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
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