The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.

Journal: Nature reviews. Cancer

This review discusses how non-cancer medications commonly used during anticancer treatment influence outcomes with immune checkpoint inhibitors (ICIs).

Key points:

  • Routine concomitant drugs: Many routine concomitant drugs (for comorbidities or symptom control) have immunomodulatory effects that can alter ICI efficacy and toxicity, yet their impact is not well characterized in practice.
  • Effects synthesized in the article:
    • Antitumor immune responses: How these agents affect antitumor immune responses and clinical benefit from ICIs.
    • Immune-related adverse events: How they influence the incidence, type, and severity of immune-related adverse events.
  • Highlighted drug classes:
    • Drugs that may blunt ICI efficacy: For example, through systemic immunosuppression or microbiome disruption.
    • Drugs that may enhance ICI responses: Classes that might enhance ICI responses or be rationally combined with ICIs because of favorable immune effects.
  • Repurposing opportunities: The authors explore the concept of repurposing immunomodulatory drugs originally used for other comorbid conditions to improve ICI outcomes, either by boosting antitumor immunity or by more selectively managing immune-related toxicity.

Overall message: The review emphasizes the need to systematically consider and study concomitant medications as a modifiable determinant of ICI response and safety in everyday oncology practice.

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