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Drugs targeting immune checkpoint molecules such as CTLA-4, PD-1, and PD-L1 are being heralded as a breakthrough in oncology. However, “breakthrough” is a misnomer belying several decades of basic immunology advances and clinical trial and error leading up to this point. It was only after basic science uncovered the protean pathways restraining anti-tumor immunity that we could begin to unravel how to subvert them. The broad activity spectrum of PD-1 pathway blockers against multiple cancer types has validated this as a “common denominator” treatment approach and dispels the perception that “immunogenic” cancers are anomalies.
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