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INTRODUCTION

Cancer remains one of the nation’s most visible and important public health challenges. National Cancer Institute data indicate the lifetime risk of developing cancer is 42% for males and 38% for females, while the risk of death is 23% and 19%, respectively.¹ While it is still high, these risks have diminished in recent years through improved diagnosis and treatment. Today, cancer is more often diagnosed in early stages when the potential for surgical resection and cure is the greatest. The availability of new modalities of systemic therapy has improved outcomes in many types of cancer. These revolutionary treatments, particularly those exploiting the biology of cancer immunology, have changed the therapeutic landscape, leading one observer to note that oncology is entering a “Golden Age” of care.²

Until the end of the 20th century, predominant systemic therapies focused on the tumor cell. The perception was that the best results could be achieved by eliminating the cancer cells themselves.³ However, these various chemotherapies, which remain essential components in the treatment and management of patients with solid and hematologic malignancies, are indiscriminately cytotoxic. As a result, they produce a host of characteristic side effects that can be extremely debilitating, and at best, they often are incompletely curative. In contrast, immunotherapeutic drugs achieve their effects by targeting specific components of the innate and adaptive immune systems. In so doing, these treatments interrupt specific pathways that are essential to tumor development and have become the standard of care in patients with metastatic melanoma (MM) and are valuable treatment options for refractory patients with non-small–cell (NSCLC), renal cell carcinoma (RCC), urothelial carcinoma. and Hodgkin lymphoma.^4-9 These drugs, which have increased overall survival (OS) with durable responses, include ipilimumab, a cytotoxic T lymphocyte-associated protein-4 (CTLA-4) antagonist, and nivolumab and pembrolizumab, 2 anti-programmed cell death protein-1 (PD-1) antibodies.^10-18 The focus of this activity is to help participants understand the role of immune checkpoint inhibition.