Checkpoint blockers for skin cancer – effects in the periphery vs the central sites

Martin Mihm, Jr., MD of Brigham and Women’s Hospital, Boston, MA, discusses the importance of therapeutic checkpoint blockers at the 2016 World Congress of Cancers of the Skin (WCCS) and the Congress of the European Association of Dermato-Oncology (EADO) in Vienna, Austria. He believes that the discovery of this therapy has extended the capacity to treat various tumors. He highlights that since checkpoint blockades are present in all people, ideally more tumors will be responsive. Next, he discusses the excitement around the subject. Pembrolizumab acts in the periphery where the tumor is located, whereas the ipilimumab acts centrally at the node or thymus, where the antigen is presented. He describes that those sites are much more subjected when there is a release in the immune system (e.g.. at in the thymus gland) and many of the diseases that have been controlled, for example connective tissue disease, can occur as a complication of the therapy; whereas there is much less complication in the periphery.

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