Dr. Osipov on the Role of Combination Immunotherapy Across Multiple Tumor Types

Arsen Osipov, MD, a medical oncologist and clinical-translational investigator in the Gastrointestinal Disease Research Group and Pancreas Cancer Research Group of the Samuel Oschin Cancer Center at Cedars-Sinai, discusses the role of combination immunotherapy across multiple tumor types.

Checkpoint inhibitors were brought into the spotlight in cancer care following the 2011 FDA approval of ipilimumab (Yervoy) for patients with advanced melanoma, according to Osipov. Following this approval, the field of oncology moved past single-agent checkpoint inhibitors and pivoted to focus on combination regimens, one of the most notable of which is PD-1 and PD-L1 inhibitors with anti-CTLA-4. This strategy has since led to other FDA approvals, Osipov says.

The rationale for the regimen is that it allows for T cell priming. The anti-CTLA-4 has a different mechanism of action that primarily impacts the lymph nodes, whereas PD-1 and PD-L1 inhibitors affect the tumor site. The combination elicits a synergistic effect that can lead to improvements in certain tumor types at the cost of toxicity, Osipov explains. Approaches with dual checkpoint inhibitors have led to approvals in the treatment of melanoma, renal cell carcinoma, and micro satellite instability–high or mismatch repair deficient colorectal cancer, Osipov concludes.