ISLAMABAD, September 20 — Cancer immunotherapy, the approach that harnesses the body’s own immune system to fight tumours, has become the fourth pillar of cancer treatment alongside surgery, radiation and chemotherapy, and its advances are directly reshaping patient outcomes. The field’s modern era began with the 2011 US Food and Drug Administration approval of ipilimumab (Yervoy), the first immune checkpoint inhibitor — a monoclonal antibody targeting CTLA-4 that improved overall survival in metastatic melanoma.
In 2014 the FDA approved pembrolizumab (Keytruda) and nivolumab (Opdivo), both PD-1 inhibitors, followed by drugs targeting PD-L1. These agents are now used across more than 20 cancer types, including melanoma, non-small cell lung cancer, kidney cancer, bladder cancer and Hodgkin lymphoma.
A Nobel Prize and a Second Pillar
The 2018 Nobel Prize in Physiology or Medicine was awarded to James P. Allison of the University of Texas MD Anderson Cancer Center and Tasuku Honjo of Kyoto University for their discovery of cancer therapy by inhibition of negative immune regulation. A second pillar, chimeric antigen receptor (CAR) T-cell therapy, was validated when the FDA approved tisagenlecleucel (Kymriah) in August 2017 for pediatric and young adult B-cell acute lymphoblastic leukemia, and axicabtagene ciloleucel (Yescarta) in October 2017 for certain large B-cell lymphomas.
Both are engineered from a patient’s own T cells. In 2022 the FDA approved teclistamab (Tecvayli), a bispecific T-cell engager, for relapsed or refractory multiple myeloma, and in 2023 approved the first tumour-infiltrating lymphocyte (TIL) therapy, lifileucel (Amtagvi), for unresectable or metastatic melanoma.
Vaccines and Oncolytic Viruses
Cancer vaccines have also advanced. An mRNA-based personalized vaccine, mRNA-4157 (V940), developed by Moderna and Merck, showed a 44% reduction in the risk of recurrence or death versus pembrolizumab alone in high-risk stage III/IV melanoma in a phase 2b trial reported in 2023, and phase 3 trials are ongoing in melanoma and non-small cell lung cancer. In 2024, an mRNA vaccine for pancreatic cancer developed by BioNTech and Genentech showed promise in a small phase 1 trial.
The field has also produced the first FDA-approved oncolytic virus, talimogene laherparepvec (Imlygic), in 2015 for melanoma, and the 2018 approval of the first checkpoint inhibitor for an earlier-stage cancer, adjuvant pembrolizumab in melanoma.
What Patients Have Gained
Patients have benefited. Long-term survival in metastatic melanoma, once measured in months, now exceeds a decade for a subset of patients, and CAR-T therapies have produced durable remissions in some blood cancers. Challenges remain, including high costs, access disparities, severe side effects such as cytokine release syndrome and neurotoxicity, and limited effectiveness in solid tumours.
For patients and families weighing these options, the encouraging part is that the science continues to move forward, with new approvals and ongoing trials expanding what is possible. The next milestones to watch are the phase 3 vaccine trials in melanoma and non-small cell lung cancer, and further work to extend immunotherapy’s reach into solid tumours. Consult your doctor for medical advice.
