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Development of Immunotherapy Combination Strategies in Cancer

Journal

CANCER DISCOVERY
Volume 11, Issue 6, Pages 1368-1397

Publisher

AMER ASSOC CANCER RESEARCH
DOI: 10.1158/2159-8290.CD-20-1209

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Harnessing the immune system to treat cancer through inhibitors of CTLA4 and PD-L1 has revolutionized cancer treatment. Rational combination strategies require a deep understanding of immune system mechanisms and strong drug development strategies. Approved immunotherapy combinations, promising combinatorial approaches in clinical trials, and innovative preclinical model systems hold great potential to improve patient outcomes in cancer treatment.
Harnessing the immune system to treat cancer through inhibitors of CTLA4 and PD-L1 has revolutionized the landscape of cancer. Rational combination strategies aim to enhance the antitumor effects of immunotherapies, but require a deep understanding of the mechanistic underpinnings of the immune system and robust preclinical and clinical drug development strategies. We review the current approved immunotherapy combinations, before discussing promising combinatorial approaches in clinical trials and detailing innovative preclinical model systems being used to develop rational combinations. We also discuss the promise of high-order immunotherapy combinations, as well as novel biomarker and combinatorial trial strategies. Significance: Although immune-checkpoint inhibitors are approved as dual checkpoint strategies, and in combination with cytotoxic chemotherapy and angiogenesis inhibitors for multiple cancers, patient benefit remains limited. Innovative approaches are required to guide the development of novel immunotherapy combinations, ranging from improvements in preclinical tumor model systems to biomarkerdriven trial strategies.

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