Immuno-oncology (IO) and checkpoint blockade
Treatments that take the brakes off the patient's own immune system so it attacks the cancer, chiefly antibodies against PD-1, PD-L1 and CTLA-4. 'IO' is industry shorthand; 'chemo-IO' means chemotherapy plus a checkpoint inhibitor, the commonest first-line combination.
Since ipilimumab (2011) and pembrolizumab/nivolumab (2014), checkpoint inhibitors have become standard in melanoma, lung, kidney, bladder, head and neck, liver, gastric, oesophageal, cervical, endometrial, triple-negative breast and MSI-high cancers, and in curative settings before and after surgery. Benefit tracks PD-L1 expression, tumour mutational burden and MSI status but imperfectly; 'cold' tumours (pancreatic, prostate, MSS colorectal, most glioblastoma) remain resistant, and roughly 40% of responders eventually progress. Immune-related adverse events affect any organ. Next steps include LAG-3, TIGIT (mixed), PD-1×VEGF bispecifics (ivonescimab), and combining IO with ADCs.
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