Introduction
Introducing low-dose immunotherapy for cancer opened new horizons in treating and managing the condition. Recent studies say that new immunotherapy drugs helped many individuals with head and neck cancer live a longer and happier life. Moreover, the United States and Europe use low-dose immunotherapy at 6%, making it more affordable.
This article will highlight the role of low-dose immunotherapy. We’ll discuss its definition, mechanism, and clinical trials. So, if you’re ready to discover interesting facts about the new immunotherapy for cancer, continue reading.
What is Low-Dose Immunotherapy?
Immunotherapy is the conventional method of treating and managing difficult cases of cancer. The traditional way refers to administering maximum tolerable doses in phase one studies. But with low-dose immunotherapy, the dosing is significantly reduced. The benefits include lower costs and fewer side effects.
Mechanism of Action
Checkpoint inhibitor anticancer drugs known as PD-1 and PD-L1 inhibitors target the immune checkpoint proteins PD-1 and PD-L1 on the surface of cells. These drugs are increasingly being used as a first-line treatment for several types of cancer. By blocking the interaction between PD-L1 and its receptor PD-1, these inhibitors disrupt the suppression of the immune system. This suppression normally occurs after infection to limit the killing of host cells and prevent autoimmune disease. The PD-1/PD-L1 immune checkpoint is also active in pregnancy, following tissue transplants, and in various types of cancer.
How successful is immunotherapy? In cancer, the interaction of PD-L1 on tumor cells with PD-1 on T-cells decreases T-cell function. It stops the immune system from eliminating the tumor cells. Blocking this interaction with an inhibitor can prevent cancer from evading the immune system, and PD-1 and PD-L1 inhibitors are being tested for use in various cancer types. These inhibitors appear to shrink tumors in more patients. They are associated with lower toxicity levels than other immunotherapies, but resistance is still an issue for many patients. PD-L1 inhibitors are considered the most promising drug category for many cancers, and assays measuring PD-L1 levels can predict response likelihood. A higher mutation burden is also predictive of response to these agents. PD-1 and PD-L1 inhibitors are related to CTLA4 inhibitors, and clinical trials are exploring the use of combination therapies with other immunotherapy drugs.
Clinical Data
How effective is immunotherapy for cancer? According to data from phase 1 studies that used multiple dose levels, the response to immunotherapy does not decrease as the dose decreases. This suggests that lower doses may have efficacy similar to higher doses, and the dose-response curve for immunotherapy does not seem linear. Additionally, a retrospective analysis by Yoo et al. found that low-dose immunotherapy with nivolumab was just as effective as the standard dose. During the 5.2-month follow-up in this study, the objective response rate was not significantly different between the standard-dose and low-dose groups, and the median overall survival was longer in the low-dose group. These results suggest that low-dose nivolumab is worth further investigation.
However, as mentioned earlier, immune checkpoint inhibitors can cause a range of immune-related adverse events, interstitial pneumonitis, hepatitis, thyroiditis, colitis, skin reactions, low platelet, white blood cell counts, and inflammation of the spinal cord or brain, neuromuscular adverse events like myositis, Guillain-Barré syndrome, and myasthenia gravis. Additionally, immune checkpoint inhibitors have been associated with myocarditis, cardiac insufficiency, acute adrenal insufficiency, and nephritis, with acute interstitial nephritis being the most common kidney-related adverse effect, followed by glomerular diseases and tubular damage. The exact mechanism underlying these negative effects is not fully understood.
Still, they are thought to be related to the dysregulation of T cells or the development of autoantibodies. However, memory T cell responses against occult viral infections may also be involved in some patients with advanced melanoma who receive combined PD-1/CTLA-4 blockade. Compared to standard chemotherapeutic agents, PD-1/PD-L1 inhibitors have a lower reported incidence of fatigue, sensory neuropathy, diarrhea, bone marrow suppression, loss of appetite, nausea, and constipation.
In the phase 3 clinical trial, 151 people with head and neck cancer (advanced) were randomly assigned to receive either standard or standard treatment with low-dose nivolumab. Patients in the immunotherapy group were given 20 mg of nivolumab every 3 weeks. In contrast, in the United States, patients are typically given 240 mg every 2 weeks. After one year, 43% of people in the immunotherapy group and 16% in the standard treatment group were still alive. Patients in the immunotherapy group lived for a median of 10 months, compared with 7 months for those in the traditional treatment group. The immunotherapy treatment also led to a higher tumor response rate and longer disease control. The survival benefit of the low dose of nivolumab was similar to what’s been seen in studies of the full amount.
A study conducted in India found that an ultra-low dose of the immunotherapy drug nivolumab improved the survival rate of patients with advanced head and neck cancer. The ultra-low quantity was added to the standard treatment in India. The combination more than doubled the percentage of patients still alive after one year compared to those who received standard therapy alone.
The low dose also decreased the cost of therapy to 5-9% of the price of full-dose immunotherapy regimens, making it more affordable for patients in low- and middle-income countries. Nearly 70% of cancer deaths globally occur in low- and middle-income countries. The study’s findings highlight opportunities to test lower doses of nivolumab for people with other kinds of cancer and explore whether lower doses of other immunotherapies may also be effective.
What is the success rate of immunotherapy? This is the first randomized study to demonstrate that adding low-dose nivolumab to metronomic chemotherapy improves OS in patients with advanced head and neck squamous cell carcinoma who cannot access full-dose checkpoint inhibitors. The combination of low-dose nivolumab and metronomic chemotherapy is an alternative standard of care that can improve outcomes without increasing the rate of adverse events.
Conclusion
Developing low-dose immunotherapy regimens benefits doctors, patients, and the entire community interested in cancer management. Additional research is highly encouraged to provide access to those affected by the prohibitive costs. After all, cancer therapy aims to offer a safe and efficient treatment for everyone in need.
Experience Safe and Effective Low-Dose Immunotherapy in Texas
Suppose you’ve found yourself Google searching “low-dose immunotherapy doctors near me” or “immunotherapy clinical trials in Texas,” hoping to find a medical facility that provides low-dose immunotherapy for cancer. We can say with certainty you’ve come to the right place.
Our cancer specialist Dr. Zhang offers conventional and innovative cancer therapies with years of experience. He uses evidence-based techniques tailored to your personal needs. Regain the upper hand over cancer and live a happier life.
Book an appointment by calling us at 7137971900.
