Cancer treatment strategies have progressed tremendously from the time when chemotherapy and radiation were the only available options for patients with inoperable tumours. Today, many treatment paradigms focus on a precision medicine approach to help ensure that patients receive the right treatment at the right time. Healthcare professionals (HCPs) now have an array of sophisticated options at their disposal to help patients live longer, including next-generation immunotherapies that galvanise the body’s natural defences and antibody-drug conjugates (ADCs) that precisely target tumours, as well as nuanced strategies to help prevent treatment resistance and disease progression.
While these innovations have produced breakthrough results in some types of cancer, many in the field believe that carefully designed combination therapies are the next frontier to help advance patient outcomes. By combining different treatment options – especially those involving immuno-oncology (IO) – researchers aim to develop approaches that can fight cancer from multiple angles, ultimately aiming to elevate standards of care.
The rise of immunotherapies
One of the most significant therapeutic developments in cancer treatment over the last few decades has been immunotherapy, particularly checkpoint inhibitors like PD-1 and PD-L1 inhibitors. These agents work by preventing tumour cells from ‘switching off’ the immune response, thereby enabling the immune system to attack the cancer. For some patients, these medicines have been game changers, increasing survival while having fewer side effects than prior treatment options like chemotherapy.
However, not all cancers respond to immunotherapy, and treatment resistance can emerge in patients over time following initial response. Researchers believe this could be overcome by using multiple immunotherapies together – or by pairing IO with other treatment modalities, such as ADCs. In principle, this approach works to amplify the immune attack while simultaneously dismantling the various shields that cancer cells use to hide or adapt.
Yet the concept of combining immunotherapies requires careful balance. Broadly speaking, each immunotherapy medicine may trigger a different type of response from the immune system, so eliciting multiple responses simultaneously could risk significant side effects for the patient
A fine balance must be struck: sufficient immune activation to eliminate more tumour cells than with a single IO approach but not so much that patients experience unacceptable side effects.
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