Article and Video CATEGORIES

Cancer Journey

Search By

Immunotherapy Combinations: Is this the Future for Treating Lung Cancer?
GRACE Videos and Articles
GRACE Cancer Video Library - Lung



As we learn more about immunotherapy for lung cancer, combinations with multiple immunotherapy agents are being explored. Medical oncologist Dr. Eddie Garon considers whether combinations are likely to emerge as the leading immunotherapy approach.

Download Transcript

[ratingwidget post_id=0]

Please feel free to offer comments and raise questions in our Discussion Forums.



So, as a research community, I feel like we’ve come a long way. It used to be, even not so long ago, that you would have a new drug, and that the first thing you would do is try to figure out how to add it to all of the established regimens that we were using. Now, that is not the initial development of the checkpoint inhibitors — the initial development has been looking at the single agent, and looking at checkpoint inhibitors as an alternative to chemotherapy. That being said, in this development, we’re sort of now moving back to that, where we’re seeing an effort to incorporate the immune checkpoint inhibitors, along with other approaches — things like chemotherapies, targeted therapies, and those are clinical trials that are under way.

Now, there is certainly some biologic rationale for this, in that, one thought is that if you are able to destroy cancer cells, that you basically would, it’s sometimes described as free-up an antigen, or free-up targets, for the immune system, and that therefore, it would be a more effective approach. There certainly are a host of studies underway, looking at adding checkpoint inhibitors to standard chemotherapy, and to most of the targeted therapies that have been developed — that is something that you are certainly seeing.

So, one of the areas that people have been interested in looking at is actually combining PD-1 or PD-L1 inhibitors with other immune checkpoints, and the ones that has been most extensively evaluated have been inhibitors of CTLA-4, and some of the reason for this is actually practical — there is a CTLA-4 inhibitor, Yervoy, that is clinically available because it’s used to treat metastatic melanoma, so any drug company can run a study with Yervoy. Yervoy is an expensive drug, and so it’s an expensive study to run, but it can be done. Also, Bristol-Myers Squibb who makes Opdivo also makes Yervoy, and MedImmune is a drug company now owned by AstraZeneca, that is developing both an inhibitor of PD-L1, as well as CTLA-4.

There has been some intriguing data looking at that combination specifically, and there have been some indications that, perhaps in patients who have low level of staining for PD-L1, that you can effectively treat those patients with the combination of agents. I’m a little cautious on those studies, in that the toxicity is clearly higher when you combine a CTLA-4 inhibitor with a PD-1 and PD-L1 inhibitor, and although the numbers to date look quite good, I’m concerned that that may be in a more robust group of patients, as not everyone who I would feel good about putting on a single agent PD-1 or PD-L1 inhibitor study, would I also feel good about putting on one of these combination studies. So, I am very eager to see if some of the promising data that has been seen to date with this combination of a PD-1 or PD-L1 inhibitor with a CTLA-4 inhibitor can be shown on a broad scale, in a larger group of patients.

In addition, our understanding of immunology has certainly increased over time, and there are other immune checkpoints, as well as vaccines, and other immune-based approaches that people are starting to look at in the setting of clinical trials. I think there are a host of exciting clinical trials out there — it will be interesting to see the outcome, I’m sometimes concerned that maybe the clinical trials are getting ahead of where the science are, and that some of these can be associated with harm, but on the other hand, it will be interesting to see what the results are, and it is an exciting time in immunotherapy, certainly.

Next Previous link

Previous PostNext Post

Related Content

Blood Cancer OncTalk
In this series of videos, Dr. Aaron Goodman chairs the discussion along with speakers Drs. Tycel Phillips, Sridevi Rajeeve, Marco Ruiz and Alankrita Taneja.  Topics include:
View the full Targeted Therapies in Lung Cancer Patient forum from 2023 in YouTube and embedded here! 

Forum Discussions

Hi Amber, Welcome to Grace.  I'm so sorry you're going through this scare.  It could be a recurrence.  It also is as likely to be the contrast creating a better view. ...

Hi Blaze,


As much as I hate to say it, Welcome back Blaze.  It sounds like you're otherwise feeling good and enjoying life which is a wonderful place to be. ...

Waiting for my appointment with oncologist this morning. Thank you for the response. It helps. <3

It sounds like you’re thinking of this in a very appropriate way. Specifically, it sounds like the growth of the nodule is rather modest, though keep in mind that the change...

Hi and welcome to GRACE.  I'm sorry your mom is having this difficulty.  An indwelling catheter is used when the pleura space continually fills and the catheter is always there to...

Recent Comments

Hi Amber, Welcome to Grace. …
By JanineT GRACE … on
Could you
By Maeve785 on
It sounds like you’re…
By Dr West on
Thank you Janine
By blaze100 on