Essential Questions to ask if you or a loved one has been diagnosed with Mesothelioma ***IMPORTANT***

Checkpoint Inhibitors Class of Cancer Immunotherapy Drugs

Posted on: October 29, 2023 *Updated on: May 27, 2024

Checkpoint inhibitors represent a groundbreaking class of drugs in cancer immunotherapy, including for the treatment of mesothelioma.

The PD-1/PD-L1 interaction is a normal mechanism that the body uses to prevent excessive immune activation, which could otherwise lead to autoimmune diseases or other types of tissue damage. However, many types of cancer cells, including mesothelioma cells, have evolved to exploit this mechanism. They overexpress PD-L1, thereby engaging PD-1 on T-cells and inhibiting the immune response against the tumor.

By using checkpoint inhibitors like pembrolizumab (Keytruda), nivolumab (Opdivo), durvalumab (Imfinzi), and atezolizumab (Tecentriq), clinicians aim to “unleash” the T-cells, enabling them to recognize and attack the cancer cells. Here’s how these drugs generally work:

  1. Blocking PD-1/PD-L1 Interaction: These drugs can either target PD-1 on the T-cells or PD-L1 on the cancer cells, disrupting the interaction that would normally inhibit T-cell activation.
  2. T-Cell Activation: With the PD-1/PD-L1 blockade in place, T-cells are free to become activated when they recognize cancer-specific antigens.
  3. Immune Response: Once activated, these T-cells can target and kill the cancer cells, ideally leading to tumor shrinkage and improved clinical outcomes.
  4. Systemic Effects: Because these drugs act on the immune system, their effects can be systemic, potentially targeting not just a single tumor but metastatic cancer throughout the body.

While checkpoint inhibitors have shown promise in treating several types of cancer, they are not without risks and limitations:

  1. Autoimmune Reactions: By amplifying the immune response, checkpoint inhibitors can sometimes cause the immune system to attack normal tissues, leading to autoimmune-like symptoms.
  2. Effectiveness: Not all patients respond to these treatments, and even among responders, the duration of response can vary.
  3. Combination Therapy: Often, checkpoint inhibitors are used in combination with other treatments, such as chemotherapy, radiation, or other immunotherapies, to improve their effectiveness.
  4. Cost: These drugs can be quite expensive, which can limit their accessibility.

Clinical trials are ongoing to evaluate the safety and effectiveness of checkpoint inhibitors in various settings, including their use in mesothelioma. Always consult healthcare providers for accurate diagnosis and appropriate treatment options.