The Curbsiders Internal Medicine Podcast #342 Checkpoint Inhibitors: The power, and adverse effects, of immunotherapy (ACP 2022)
Jun 27, 2022
AI Snips
Chapters
Transcript
Episode notes
How Immunotherapy Works
- Immunotherapy works by waking up the immune system to recognize and attack cancer cells rather than directly killing them.
- Checkpoint inhibitors remove T‑cell brakes (e.g., CTLA‑4, PD‑1/PD-L1) to sustain anti-tumor immunity.
Coley's Historical Experiment
- Dr. Cable described William Coley's 19th century experiments giving killed bacterial toxins to treat sarcoma, sometimes triggering tumor shrinkage.
- He used this history to illustrate early attempts to harness inflammation against cancer.
Checkpoint Blockade Basics
- CTLA‑4 and PD‑1/PD‑L1 inhibitors prevent T‑cell shutdown and thereby prolong T‑cell activity against tumors.
- Downstream immune effects are complex and can involve many T‑cell types and B‑cell cross‑talk.