Overview-immunotherapy and cellular therapy

immunotherapy and cellular therapy

• Immune checkpoints: co-inhibitory signaling molecules that limit immune responses
• Cytotoxic T-lymphocyte-assoc. protein 4 (CTLA-4): ↓ T cell activation via negative signals and ligand competition w/ CD28 (activating co-stim. molecule).
• Programmed cell death protein 1 (PD-1): on activated T cells, turns off T cell responses
• Prog. death-ligand 1 (PD-L1): PD-1 ligand expressed on tumor and/or immune cells

ICIs (Annals of Oncol 2017;28:2377)

Target: PD-1

Drugs: Nivolumab Pembrolizumab Cemiplimab Dostarlimab Select Indications : Melanoma, NSCLC, RCC, HNSCC, esoph., endometrial, MSI-high tumors Common Adverse Events (approx. incidence, any grade) Rash (12%); hypothyroid (5%); pneumonitis (2%); colitis (<1%); hepatitis (<1%); type 1 DM (<1%)

Target: PD-L1

Drugs: Atezolizumab Avelumab Durvalumab Select Indications : Urothelial carcinoma, NSCLC, SCLC, HCC (atezo) Common Adverse Events : Rash (5%); hypothyroid (2%); adrenal insufficiency (<1%); colitis (<1%); pneumonitis (<1%)

Target: CTLA-4

Drugs: Ipilimumab Select Indications : Melanoma, RCC (w/ PD1), mesothelioma (w/ PD1) Common Adverse Events (approx. incidence, any grade) Rash (21%); colitis (5%); hypophysitis (1%); hypothyroid (1%); pneumonitis (<1%); hepatitis (<1%)