Dr. Sheikh Abid Ali
National Institute of Biologicals (MoHF), Noida, (UP) India
The success of immune checkpoint inhibitors against several tumours has promoted a new treatment strategy in clinical oncology, and this has encouraged physicians to increase the number of patients who receive immune checkpoint therapy, including clinical activity in neuroendocrine tumours. Here, we review the main concepts regarding immune checkpoint mechanisms and how cancer disrupts them to undergo immune escape. We describe the most essential concepts related to present the challenges and the opportunities of using immune checkpoint inhibitors against these endocrine malignancies, highlighting the breakthroughs and pitfalls that have recently emerged. Results revealed that the five approved checkpoint inhibitors and several that are currently in clinical pipelines. By blocking the interaction between CTLA-4 and B7-1/2 (e.g., ipilimumab) or PD-1 (e.g., nivolumab and pembrolizumab) and PD-L1 (e.g., durvalumab, atezolizumab and avelumab), immune checkpoint inhibitors inhibit the immune response mediated by immune escape mechanisms and encourage the immune system to destroy tumour cells.
Endocrine neoplasms are increasingly being addressed by using this therapeutic modality, and several ongoing studies are being conducted on patients with endocrine cancers. Notably, some tumour types (e.g., pancreatic adenocarcinoma, adrenocortical carcinoma and neuroendocrine tumours) require further study because the available data in the literature are not sufficient for clinical translation. Immune checkpoint inhibitors have revolutionized cancer management and the last 5 years have seen a rapid expansion in the indications for this class of drug.
Endocrine Neoplasms, Immune Checkpoint Inhibitors, Neuroendocrine Tumour, Immune Escape
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