Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: New Immunotherapy Agents for Cancer (Part 1)
Dr Natalie Soulsby, Director of Clinical Operations
Traditional chemotherapeutic agents have been around for many years and interfere with cell division. We know that these agents are not specific to the cancer cells and can cause damage to rapidly dividing non-malignant cells, thus causing the large range of adverse effects we see with these drugs. These new Immunotherapy agents deal directly with the immune system and can have a profound effect on treatment outcomes.
- In the immune system T cells (or T-lymphocytes) play an integral role in providing cell mediated immunity having a direct impact on killing malignant cells which is where the immunotherapy agents target. There are currently three of these agents available in Australia: ipilimumab, nivolumab and pembrolizumab.
- Ipilimumab is PBS listed for metastatic or unresectable melanoma. It binds to the cytotoxic T lymphocyte antigen 4 (or CTLA-4) which causes an enhanced T cell mediated immune response thus increasing the death of the tumour cells.
- Nivolumab is PBS listed for melanoma and non-small cell lung cancer and pembrolizumab is PBS listed for metastatic and unrescectable melanoma.
- These drugs act as Program Cell Death Inhibitors (PD1 inhibitors), which allow the T cells to remain active and able to continue to attack the tumour cells. These three agents are now considered first line treatment in melanoma as they have greatly increased the response rate to treatment.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.