Many patients ask their oncologist: “what about immunotherapy for my cancer?” There are several forms of immunotherapy, but the ones most commonly used are called “checkpoint inhibitors,” or CPIs, which come under medication names like pembrolizumab, ipilimumab and nivolumab.

Why doesn’t our body’s immune system recognize cancer cells as foreigners and destroy them like it does bacteria or viruses? It turns out that cancer cells can inhibit immune cells when they are in contact with them, thus paralyzing them. This is where CPIs can help, as they release this inhibition and unleash the immune cell’s ability to attack the cancer. This is important because CPI immunotherapy, unlike chemotherapy, doesn't kill cancer cells, but it allows one’s own immune system to do it.

The benefit of CPIs is that for many patients who do respond to the treatment, the response may continue long after treatment is complete. With that said, CPIs are not "miracle" drugs. Although about 40% of patients are eligible to receive CPIs, they only significantly prolong remission or survival 15% to 20% of the time. Most patients experience mild, acute or chronic reversible side effects, but 13% of patients experience severe short-term effects and 5% suffer from long term side effects.

CPIs have been approved by the FDA for the following common cancers: melanoma, kidney and bladder cancer, head and neck cancer, non-small cell lung cancer, Hodgkin’s lymphoma, cervical cancer and some gastroinestinal malignancies. Researchers are developing ways to determine which patients are likely to respond to CPIs. We know that tumors with multiple mutations or those cancers with high levels of an antigen called PDL-1 on their surface have a very high chance to respond. CPIs are sometimes more effective when given along with chemotherapy.

The future is bright for immunotherapy, with CPIs being only one of several treatments that have proven to be successful. This is an area of intense research -- as of February 2022, the FDA has approved over 60 immunotherapies that target almost every major cancer type.

Below is additional information on immunotherapy and questions to ask your care team. As always, don't hesitate to reach out to our team if you have any questions.