What Immune checkpoint inhibitors are available in the united states? What are the indications for use of Immune checkpoint inhibitors?
Several ICPIs are currently approved by the U.S. Food and Drug Administration (FDA). Ipilimumab, a CTLA-4 inhibitor, was the first agent approved for use in patients with advanced melanoma. Available PD-1 inhibitors are nivolumab and pembrolizumab. Nivolumab is approved for patients with metastatic melanoma, previously treated metastatic non–small cell lung cancer (NSCLC), recurrent or metastatic squamous cell carcinoma of the head and neck, advanced renal cell carcinoma (often in combination with ipilimumab), hepatocellular carcinoma (previously treated with sorafenib), relapsed or progressive classical Hodgkin’s lymphoma (after autologous hematopoietic stem cell transplantation), and certain cases of metastatic colon carcinoma. Pembrolizumab is approved for advanced melanoma, advanced NSCLC, head and neck squamous cell cancer, classical Hodgkin’s lymphoma, advanced urothelial cancer, tumors that have microsatellite instability-high (MSI-H) or are mismatch repair deficient, and advanced gastric adenocarcinoma. Available PD-L1 inhibitors are atezolizumab (approved for urothelial cancers and NSCLC), durvalumab (approved for urothelial cancers), and avelumab (approved for Merkel cell carcinoma and urothelial carcinoma). Indications for use of these therapies are rapidly changing and multiple drug combinations are being tested in a variety of cancers.