Low doses in immunotherapy: Are they effective?

Abstract

Checkpoint inhibitors are versatile immunomodulatory agents, and they are being approved for the treatment of an increasing number of cancers, based on the demonstration of clinical benefits. While they have changed the landscape of treatment of many cancers, they remain inaccessible to most patients, especially in low-income countries because of their prohibitive costs. Conventionally, chemotherapy drug doses are decided based on the maximum tolerable dose in phase 1 studies, but this dose-finding methodology is not applicable to targeted therapies where dose-limiting toxicity is not reached at doses much higher than sufficiently active doses. This review article focuses on how lower doses of immunotherapy drugs could be as efficacious as the currently recommended doses, thus decreasing the financial burden.