Cancers considered "hot tumors", such as melanoma, contain antitumor T cells and may respond to checkpoint inhibitor antibodies.
Immune checkpoint inhibitors
Monoclonal antibodies are a type of cancer immunotherapy that have been developed to target immune checkpoints. These checkpoints down-regulate programmed cell death 1 or apoptosis. Cancer immunotherapy to block these checkpoints may encourage apoptosis of cancer cells.
- Exacerbation of pre-existing autoimmune disease.
These antibodies can activate the immune system to attack cancers. These antibodies target the Programmed Cell Death 1 Receptor (PD-1 Receptor or CD279). Programmed Cell Death Type I is also known as apoptosis. The PD-1 Receptor is "an inhibitory T-lymphocyte receptor that has specificity for CD274 antigen and Programmed Cell Death 1 Ligand 2 Protein."
Pembrolizumab is a 'humanized monoclonal IgG4 kappa isotype antibody against PD-1'. Pembrolizumab was approved by the FDA for “patients with unresectable or metastatic, microsatellite-instability–high (MSI-H) or mismatch-repair–deficient (dMMR) solid tumors, regardless of tumor site or histology”.  Pembrolizumab creates more objective tumor response among tumors in which at least 50% of its cells express PD-L1.
These antibodies can activate the immune system to attack cancers. These antibodies target PD-L1, or cluster of differentiation 274 (CD274) which is the transmembrane protein ligand to PD-1.
The CTLA-4 Antigen is "an inhibitory T cell receptor that is closely related to CD28 antigen. It has specificity for CD80 antigen and CD86 antigen and acts as a negative regulator of peripheral T cell function. CTLA-4 antigen is believed to play role in inducing peripheral tolerance."
Ipilimumab may cause autoimmune pituitary disease and exacerbate autoimmune disease in recipients with pre-existing autoimmune disease. The U.S. FDA has issued guidance on managing side effects.
- Ipilimumab (Yervoy)
Raf protein kinase inhibitors
Raf inhibitors are "a family of closely-related serine-threonine kinases that were originally identified as the cellular homologs of the retrovirus-derived V-RAF kinases. They are MAP kinase kinase kinases that play important roles in signal transduction."
Vaccines may provide immunotherapy of cancers.
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- Postow et al. http://www.nejm.org/doi/full/10.1056/NEJMra1703481 NEJM 2018
- Abdel-Wahab N, Shah M, Lopez-Olivo MA, Suarez-Almazor ME (2018). "Use of Immune Checkpoint Inhibitors in the Treatment of Patients With Cancer and Preexisting Autoimmune Disease: A Systematic Review". Ann Intern Med. doi:10.7326/M17-2073. PMID 29297009.
- Anonymous (2019), Programmed Cell Death 1 Receptor (English). Medical Subject Headings. U.S. National Library of Medicine.
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- Topalian SL, Hodi FS, Brahmer JR, Gettinger SN, Smith DC, McDermott DF; et al. (2012). "Safety, activity, and immune correlates of anti-PD-1 antibody in cancer". N Engl J Med. 366 (26): 2443–54. doi:10.1056/NEJMoa1200690. PMC 3544539. PMID 22658127.
- Anonymous (2019), CTLA-4 Antigen (English). Medical Subject Headings. U.S. National Library of Medicine.
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- Johnson DB, Sullivan RJ, Ott PA, Carlino MS, Khushalani NI, Ye F; et al. (2016). "Ipilimumab Therapy in Patients With Advanced Melanoma and Preexisting Autoimmune Disorders". JAMA Oncol. 2 (2): 234–40. doi:10.1001/jamaoncol.2015.4368. PMID 26633184.