Abstract IA16: Lung cancer, immunotherapy and health disparities

Abstract

Abstract In recent years, there has been a deeper understanding of the mechanisms of immune evasion by cancer cells. This has led to the development of a number of immune checkpoint inhibitors for cancer therapy. The first inhibitor to be approved was ipilumumab, a monoclonal antibody that works to activate the immune system by targeting CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), also known as CD152 (cluster of differentiation 152), a protein receptor that downregulates the immune system. Ipilimumab inhibits CTLA4, which is important for dampening T cell responses at the priming phase in lymph nodes, and is approved for the therapy of malignant melanoma. The role of checkpoint inhibitors in cancer therapy has blossomed over the last couple of years with the advent of PD1/PDL1 inhibitors. These agents are currently approved for the therapy of NSCLC, melanoma, renal cell carcinoma, bladder cancer hodgkins lymphoma and head and neck cancer. The approved agents are nivolumab, pembrolizumab and atezolizumab. A number of other checkpoint inhibitors are in development. Lung cancer mortality is disproportionately high in minority populations. Pembrolizumab and nivolumab are approved for the second line therapy of non-small cell lung cancer and combinations of PD-1/PD-L1 inhibitors and CTLA4 inhibitors such as nivolumab/ipilimumab are being evaluated for small cell and non-small cell lung cancer. As always, a number of clinical trials have been done with these agents, but these have included very few minority patients. The clinical effects and unique toxicities of these agents will be discussed, as will their cost. Implications of these new treatment modalities for minority and underserved populations with lung cancer will also be discussed. Citation Format: Alex A. Adjei. Lung cancer, immunotherapy and health disparities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA16.