Under normal circumstances, our immune system can recognize and eliminate tumor cells. But in order to survive and grow, tumor cells can adopt different strategies to restrain the body’s immune system. Sometimes, they can even promote the development and progression of a tumor. These characteristics of tumor cells are known as immune-resistance.
Immunotherapy is a novel class of inhibitors that function as a tumor suppressing factor via modulation of immune cell-tumor cell interaction. These checkpoint blockers are rapidly becoming a highly promising cancer therapeutic approach that yields remarkable responses for patients with a broad spectrum of cancers, such as melanoma, non-small cell lung cancer and kidney cancer. In recent times, more than five immunotherapy drugs have been approved by the Food and Drug Administration (FDA) of the United States for clinical application.
Monoclonal Antibody Immune Checkpoint Inhibitors
PD-1/PD-L1 and PD-1/PD-L1 antibodies
PD-1/PD-L1 antibodies can block PD-L1 on the surface of tumor cells, reactivating the function of cytotoxic T cells to promote anticancer immune responses.
Anti PD-1 monoclonal antibodies Pembrolizumab (Keytruda™) and Nivolumab (Opdivo™) have been approved by the FDA for advanced melanoma, non-small cell lung cancer, non-Hodgkin’s lymphoma, and head and neck squamous cell carcinomas. Nivolumab has also been approved by the FDA for the treatment of kidney and urinary tract carcinomas, etc. In addition, PD-L1 inhibitors Atezolizumab (Tecentriq™), Avelumab (Bavencio™), and Durvalumab (Imfinzi™) have also been tested in Phase III clinical studies, covering many types such as non-small cell lung cancer, melanoma, and bladder cancer.
The CTLA-4 inhibitor Ipilimumab, the first approved immune checkpoint inhibitor drug, has been approved by the FDA for adjuvant treatment of Stage III melanoma and treatment for advanced melanoma.
Other monoclonal antibodies
Other monoclonal antibodies such as TNF receptor family OX40 and 4-1bb monoclonal antibodies are still under development.
Common Adverse Effects of Monoclonal Antibody Immune Checkpoint Inhibitors
Compared with chemotherapy, immune therapy generally has a lower incidence of adverse effects. Although autoimmune disorder does indeed sometimes occur, with appropriate dosage tested in Phase I clinical studies, the overall incidence of serious adverse events (Grade 3-4) is still not high.
The most common adverse effects are fatigue, loss of appetite, nausea, weakness, and rash. Most adverse effects are reversible and manageable.
Immunotoxicity can occur at any time. According to the median time of onset, it can be divided into early (< 2 months) and late (> 2 months) toxicity. Early toxicity includes skin, gastrointestinal, and liver. Late toxicity includes lung, endocrine glands, and kidney. Some are delayed, with some even occurring after a year of immunotherapy.
In case of any adverse effects related to immunotherapy, please contact the medical staff promptly.
We can provide the below immunotherapy medications：
- Nivolumab: is used for the treatment of melanoma, non-small cell lung cancer, renal cell cancer, colorectal cancer, and classical Hodgkin’s lymphoma.
- Pembrolizumab (Keytruda): is used for the treatment of melanoma, non-small cell lung cancer, head and neck squamous cell carcinoma, and Merkel cell carcinoma.
- Atezolizumab (Tecentriq): is used for the treatment of non-small cell lung cancer, bladder cancer, and urothelial carcinoma.
- Ipilimumab: is used for the treatment of melanoma, and non-small cell lung cancer.
- Durvalumab: is used for the treatment of bladder cancer and non-small cell lung cancer.
- Pazopanib: is used for the treatment of renal cell cancer, soft tissue sarcomas, and advanced differentiated thyroid carcinoma.
- Pertuzumab: is used for the treatment of human epidermal growth factor receptor (HER) and breast cancer.
- Lapatinib: is used for the treatment of human epidermal growth factor receptor (HER) and breast cancer.
- Denosumab: is used for the treatment of metastatic tumor of bone, osteoporosis, and giant cell tumor of bone.
- Dabrafenib: is used for the treatment of melanoma.