The medicines used in modern immunotherapy do not attack the tumour cells directly, but instead direct the body’s immune response towards them. This happens at locations called immune checkpoints, which function as coordinating centres within the immune system that ensure that an immune reaction is inhibited and that the system does not “overreact” and trigger an immune reaction against the individual’s own body. This is what happens in autoimmune diseases.
Tumour cells can, however, exploit this inhibiting action at the immune checkpoints to block a defensive reaction aimed at them.
This is exactly the process targeted by immune checkpoint inhibitors. They release the brake at the checkpoints, enabling the immune system to be reactivated and attack the tumour cells. The immune checkpoint inhibitors that have been on the market since 2011 are achieving impressive results in certain oncological indications such as advanced melanoma (skin cancer).
The success that has been achieved to date and current research findings in immuno-oncology show that this new therapeutic concept can play a decisive role in the treatment of various cancers. For this reason, some of the innovative active substances are already being used to treat different cancers or are being researched intensively.
Challenges in authorisation and reimbursement
The rapid development of personalised medicine is increasing the number of treatment options available for people with cancer, including combinations of chemotherapy and immunotherapy. However, some of these new medical products are not yet authorised in Switzerland. This is particularly problematic if a medicine is prescribed for an indication other than the one for which it has officially been authorised by Swissmedic. This is known as off-label use (OLU), which is not automatically reimbursed by health insurers and is judged on a case-by-case basis. The situation is similar for medicinal products that are available in other countries but not authorised in Switzerland.