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 "slug": "targeted-immunotherapy",
 "title": "Targeted immunotherapy",
 "updated": "2026-10-15",
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 "excerpt": "Targeted immunotherapy is a cancer treatment category whose agents include immune checkpoint inhibitors, bispecific T-cell engagers, and CAR T-cell therapies, first approved in 2011 for melanoma.",
 "snippet": "Targeted immunotherapy is a cancer treatment category whose agents include immune checkpoint inhibitors, bispecific T-cell engagers, and CAR T-cell therapies, first approved in 2011 for melanoma.",
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 "markdown": "# Targeted immunotherapy\n\nTargeted immunotherapy is a cancer treatment category whose agents include immune checkpoint inhibitors (ICIs), which block inhibitory receptors such as CTLA-4, PD-1, and PD-L1 that tumors exploit to escape immune attack; starting with the 2011 approval of anti-CTLA-4 for advanced melanoma, ICIs have gained regulatory approval across a wide array of cancer types.<sup>[1](https://www.annualreviews.org/content/journals/10.1146/annurev-pathol-042020-042741)</sup> The category also includes bispecific T-cell engagers that physically link T cells to tumor antigens, and engineered CAR T-cell therapies. It differs from targeted small-molecule therapy, which acts on oncogenic signaling pathways inside tumor cells rather than on immune cells.\n\n| Key fact | Detail |\n|---|---|\n| Approved checkpoint inhibitor classes | 2 anti-CTLA-4, 6 anti-PD-1, 3 anti-PD-L1, 1 anti-LAG-3 (FDA, as of 2024)<sup>[2](https://link.springer.com/article/10.1186/s12943-024-02212-7)</sup> |\n| Single-agent response rate | About 20% of patients respond to single-agent checkpoint therapy; 40–70% in melanoma, Hodgkin lymphoma, and MSI-high tumors, 10–25% in most other cancers<sup>[3](https://doi.org/10.1016/j.cell.2023.03.006)</sup><sup> • </sup><sup>[2](https://link.springer.com/article/10.1186/s12943-024-02212-7)</sup> |\n| Durable benefit in melanoma | 10-year median overall survival of 71.9 months with nivolumab plus ipilimumab in CheckMate 067<sup>[4](https://www.nejm.org/doi/full/10.1056/NEJMoa2407417)</sup> |\n| Bispecific engager example | Blinatumomab, a CD19×CD3 T-cell engager; 32% complete remission in relapsed/refractory ALL (FDA review)<sup>[5](https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/125557Orig1s000ODMemo.pdf)</sup> |\n| CAR T-cell example | Kymriah (tisagenlecleucel), first approved August 30, 2017; 82% overall response in the pivotal ELIANA ALL trial<sup>[6](https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/April-13--2018-Summary-Basis-for-Regulatory-Action---KYMRIAH.pdf)</sup><sup> • </sup><sup>[7](https://pmc.ncbi.nlm.nih.gov/articles/PMC10294746/)</sup> |\n| Principal toxicities | Immune-related adverse events in multiple organ systems; cytokine release syndrome and neurotoxicity with T-cell engagers and CAR T cells<sup>[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC11180426/)</sup><sup> • </sup><sup>[9](https://www.ema.europa.eu/en/documents/product-information/kymriah-epar-product-information_en.pdf)</sup> |\n\n## How it works\n\nCheckpoint blockade removes inhibitory signals from T cells. T-cell activation requires two signals: antigen recognition through the [T cell](https://www.edgepedia.org/t-cell) receptor (signal 1) and costimulation through CD28 binding CD80/CD86 on antigen-presenting cells (signal 2). CTLA-4, a CD28 homolog with higher affinity for the B7 ligands, outcompetes CD28 to block signal 2 and inhibit T cell proliferation and IL-2 production.<sup>[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC11180426/)</sup> PD-1 engagement by its ligands PD-L1 and PD-L2 recruits a tyrosine phosphatase that dephosphorylates signaling molecules downstream of the T cell receptor, blocking signal 1.<sup>[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC11180426/)</sup> Antibodies against CTLA-4, PD-1, or PD-L1 interrupt these brakes, allowing anti-tumor T cells to proliferate and kill.\n\nBispecific engagers force tumor–T cell synapses. Blinatumomab joins an anti-CD19 single-chain variable fragment with an anti-CD3 fragment, binding simultaneously to CD3-positive cytotoxic T cells and CD19-positive B cells so the patient's endogenous T cells recognize and eliminate CD19-positive blasts; engagement triggers T-cell activation, release of granzymes and perforins, caspase activation, and apoptosis of neoplastic B cells.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC5881572/)</sup><sup> • </sup><sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC11150604/)</sup>\n\nCAR T cells add an artificial target recognizer. Chimeric antigen receptors are synthetic receptors with an extracellular antigen-binding domain, a transmembrane domain, and intracellular signaling domains that redirect T cells against a chosen antigen. Kymriah's CAR uses a murine anti-CD19 scFv linked to CD3-ζ and 4-1BB signaling domains delivered by a lentiviral vector, while Yescarta uses a retroviral vector and CD28 costimulation.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK519046/)</sup><sup> • </sup><sup>[6](https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/April-13--2018-Summary-Basis-for-Regulatory-Action---KYMRIAH.pdf)</sup>\n\n## How it is done\n\nPatient selection rests on molecular targets and biomarkers. Pembrolizumab received a tumor-agnostic FDA approval for microsatellite instability-high (MSI-H) solid tumors, a biomarker-defined indication independent of tumor origin.<sup>[13](https://doi.org/10.1158/1078-0432.ccr-18-4070)</sup> For blinatumomab, CD19 is chosen because it is expressed on more than 90% of B-cell precursor ALL blasts, and the 2018 FDA approval covers B-ALL patients in complete remission with minimal residual disease at ≥ \\( 10^{-3} \\).<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC5881572/)</sup><sup> • </sup><sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC11150604/)</sup>\n\nCAR T-cell treatment involves collecting a patient's T cells by leukapheresis, engineering them to express the CAR, expanding them in the laboratory, and reinfusing them.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK519046/)</sup>\n\nMonitoring targets immune-mediated toxicity. Checkpoint inhibitors cause immune-related adverse events affecting the dermatological, gastrointestinal, hepatic, endocrine, pulmonary, neurological, and cardiac systems, managed with temporary immunosuppression using glucocorticoids, tumor necrosis factor antagonists, mycophenolate mofetil, or other immunoregulatory agents.<sup>[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC11180426/)</sup> After Kymriah infusion, cytokine release syndrome typically developed with a median onset of 3 days (range 1 to 22 days) in pediatric/young adult ALL patients, and is managed with tocilizumab with or without corticosteroids.<sup>[9](https://www.ema.europa.eu/en/documents/product-information/kymriah-epar-product-information_en.pdf)</sup>\n\n## Origin\n\nThe checkpoint-blockade concept grew from a sequence of immunology papers. [Theresa L. Walunas](https://www.edgepedia.org/theresa-l-walunas) and colleagues showed in 1994 that CTLA-4 can function as a negative regulator of T cell activation.<sup>[14](https://doi.org/10.1016/1074-7613%2894%2990071-x)</sup> M. F. Krummel and J. P. Allison showed in 1995 that CD28 and CTLA-4 have opposing effects on the response of T cells to stimulation.<sup>[15](https://doi.org/10.1084/jem.182.2.459)</sup> In 1996, [Dana R. Leach](https://www.edgepedia.org/dana-r-leach), [Matthew F. Krummel](https://www.edgepedia.org/matthew-f-krummel), and James P. Allison reported enhancement of antitumor immunity by CTLA-4 blockade in Science, the paper that established immune checkpoint blockade as an anticancer strategy.<sup>[16](https://doi.org/10.1126/science.271.5256.1734)</sup>\n\nOn the PD-1 side, Y. Ishida, Y. Agata, K. Shibahara, and T. Honjo reported PD-1 in 1992 as a novel immunoglobulin gene superfamily member induced upon programmed cell death.<sup>[17](https://doi.org/10.1002/j.1460-2075.1992.tb05481.x)</sup> [Gordon J. Freeman](https://www.edgepedia.org/gordon-j-freeman) and colleagues showed in 2000 that engagement of PD-1 by a novel B7 family member negatively regulates lymphocyte activation.<sup>[18](https://doi.org/10.1084/jem.192.7.1027)</sup> Yoshiko Iwai and colleagues reported in 2002 that PD-L1 on tumor cells mediates escape from the host immune system and that PD-L1 blockade is a tumor immunotherapy.<sup>[19](https://doi.org/10.1073/pnas.192461099)</sup> Y. Iwai reported in 2004 that PD-1 blockade inhibits hematogenous spread of poorly immunogenic tumor cells.<sup>[20](https://doi.org/10.1093/intimm/dxh194)</sup>\n\nClinically, F. Stephen Hodi and colleagues reported improved survival with ipilimumab in metastatic melanoma in the New England Journal of Medicine in 2010.<sup>[21](https://doi.org/10.1056/nejmoa1003466)</sup> The Nobel Prize in [Physiology](https://www.edgepedia.org/physiology) or Medicine was awarded for the discovery of cancer therapy by inhibition of negative immune regulation.<sup>[22](https://www.nobelprize.org/prizes/medicine/2018/press-release/)</sup> The pivotal melanoma combination trials were reported by [Caroline Robert](https://www.edgepedia.org/caroline-robert) and colleagues (KEYNOTE-006, 2015), [James Larkin](https://www.edgepedia.org/james-larkin) and colleagues (CheckMate 067, 2015), and Michael A. Postow and colleagues (CheckMate 069, 2015).<sup>[23](https://doi.org/10.1056/nejmoa1503093)</sup><sup> • </sup><sup>[24](https://doi.org/10.1056/nejmoa1504030)</sup><sup> • </sup><sup>[25](https://doi.org/10.1056/nejmoa1414428)</sup>\n\n## Variants\n\nIpilimumab, a human IgG1κ anti-CTLA-4 monoclonal antibody, gained FDA approval in 2011 for non-resectable stage III/IV melanoma, conferring a 3.6-month short-term survival benefit, with 22% of treated advanced melanoma patients gaining 3 years or more of life.<sup>[26](https://pmc.ncbi.nlm.nih.gov/articles/PMC7238960/)</sup> In 2014, pembrolizumab and nivolumab became the first FDA-approved PD-1-targeted therapeutics for refractory and unresectable melanoma.<sup>[26](https://pmc.ncbi.nlm.nih.gov/articles/PMC7238960/)</sup> [Atezolizumab](https://www.edgepedia.org/atezolizumab), the first PD-L1-targeted humanized antibody, was approved in 2016 for urothelial carcinoma; avelumab and durvalumab entered the market in 2017.<sup>[26](https://pmc.ncbi.nlm.nih.gov/articles/PMC7238960/)</sup>\n\nBispecific antibodies form a second variant class. Catumaxomab (anti-EpCAM × anti-CD3) was the first approved bispecific antibody, described in a 2010 review by Diane Seimetz, Horst Lindhofer, and [Carsten Bokemeyer](https://www.edgepedia.org/carsten-bokemeyer).<sup>[27](https://doi.org/10.1016/j.ctrv.2010.03.001)</sup> Blinatumomab, the second approved bispecific, received FDA accelerated approval on December 3, 2014 for [Philadelphia chromosome](https://www.edgepedia.org/philadelphia-chromosome)-negative relapsed/refractory B-cell precursor ALL as the first bispecific CD19-directed CD3 T-cell engager (BiTE) product.<sup>[28](https://investors.amgen.com/news-releases/news-release-details/fda-approves-blincytotm-blinatumomab-immunotherapy-treatment)</sup> Its key clinical development papers include the 2008 Science proof-of-concept by Ralf Bargou and colleagues and the 2011 Journal of Clinical Oncology minimal residual disease study by Max S. Topp and colleagues.<sup>[29](https://doi.org/10.1126/science.1158545)</sup><sup> • </sup><sup>[30](https://doi.org/10.1200/jco.2010.32.7270)</sup> [Cadonilimab](https://www.edgepedia.org/cadonilimab), described by Xinghua Pang and colleagues in 2023, is the first approved dual checkpoint-targeting bispecific antibody (PD-1/CTLA-4).<sup>[31](https://doi.org/10.1080/19420862.2023.2180794)</sup>\n\nCAR T cells are the third variant. Kymriah was initially approved August 30, 2017 for patients up to 25 years of age with B-cell precursor ALL, with an April 2018 action granting regular approval for adult relapsed/refractory large [B-cell lymphoma](https://www.edgepedia.org/b-cell-lymphoma) after two or more systemic therapy lines.<sup>[6](https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/April-13--2018-Summary-Basis-for-Regulatory-Action---KYMRIAH.pdf)</sup> [CAR T-cell therapy](https://www.edgepedia.org/car-t-cell-therapy) is approved for relapsed/refractory B-ALL, certain DLBCL subtypes, follicular lymphoma, mantle cell lymphoma, multiple myeloma, and CLL/SLL (e.g., lisocabtagene maraleucel, approved for CLL/SLL in March 2024), and remains investigational in most solid tumors.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK519046/)</sup><sup> • </sup><sup>[32](https://pmc.ncbi.nlm.nih.gov/articles/PMC11305028/)</sup> [Relatlimab](https://www.edgepedia.org/relatlimab) plus nivolumab, reported by Hussein A. Tawbi and colleagues in 2022, extended the checkpoint class to LAG-3.<sup>[33](https://doi.org/10.1056/nejmoa2109970)</sup>\n\n## Applications\n\nMelanoma shows the largest and most durable gains. In CheckMate 067 with a minimum 10-year follow-up, median overall survival was 71.9 months with nivolumab plus ipilimumab, 36.9 months with nivolumab, and 19.9 months with ipilimumab; median melanoma-specific survival exceeded 120 months with the combination.<sup>[4](https://www.nejm.org/doi/full/10.1056/NEJMoa2407417)</sup>\n\nLung cancer: in KEYNOTE-024, median progression-free survival was 10.3 months with pembrolizumab versus 6.0 months with chemotherapy, and the response rate was 44.8% versus 27.8%.<sup>[34](https://www.nejm.org/doi/full/10.1056/NEJMoa1606774)</sup>\n\nAcute lymphoblastic leukemia and lymphoma: in the randomized phase 3 TOWER trial, median overall survival was 7.7 months with blinatumomab versus 4.0 months with chemotherapy, and complete remission with full hematologic recovery was 34% versus 16%.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC5881572/)</sup> For Kymriah, the pivotal ELIANA trial in pediatric/young adult relapsed/refractory ALL showed an overall response rate of 82%, with 5-year relapse-free survival of 49% among patients achieving CR/CRi.<sup>[7](https://pmc.ncbi.nlm.nih.gov/articles/PMC10294746/)</sup>\n\nAcross cancers, objective response rates to ICIs range from 40–70% in melanoma, Hodgkin's lymphoma, and MSI-high tumors, but can be as low as 10–25% in most other cancers; only approximately 20% of patients respond to single-agent checkpoint therapy, prompting combination approaches.<sup>[2](https://link.springer.com/article/10.1186/s12943-024-02212-7)</sup><sup> • </sup><sup>[3](https://doi.org/10.1016/j.cell.2023.03.006)</sup>\n\n## Limitations and alternatives\n\nResistance limits durable responses. Primary resistance is associated with tumors lacking adequate immune-cell infiltration: immune-excluded tumors contain T cells retained in the surrounding stroma that fail to enter tumor nests, whereas immune-desert tumors lack substantial T-cell infiltration; acquired resistance occurs in inflamed tumors; a main extrinsic mechanism of secondary acquired resistance is compensatory upregulation of alternative inhibitory checkpoints including TIM-3, LAG-3, BTLA, VISTA, and TIGIT.<sup>[2](https://link.springer.com/article/10.1186/s12943-024-02212-7)</sup><sup> • </sup><sup>[35](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1344272/full)</sup> Secondary acquired resistance emerges in approximately 20–30% of patients treated with checkpoint inhibitors, and primary resistance to checkpoint inhibition affects approximately 50% of melanoma patients.<sup>[36](https://link.springer.com/article/10.1007/s10555-023-10097-z)</sup>\n\nTargeted small molecules are the nearest alternative in melanoma. BRAF/MEK inhibitor combinations achieve tumor response rates of 75%, progression-free survival of 11–15 months, and 5-year survival reaching 40% in metastatic BRAF-V600-mutant melanoma, but resistance develops through MAPK pathway reactivation; preclinical evidence suggests secondary resistance to MAPK inhibitors may jeopardize subsequent checkpoint inhibitor response, favoring immunotherapy first.<sup>[36](https://link.springer.com/article/10.1007/s10555-023-10097-z)</sup>\n\n## References\n\n1. [Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance (Annual Review of Pathology)](https://www.annualreviews.org/content/journals/10.1146/annurev-pathol-042020-042741)\n2. [Resistance mechanisms to immune checkpoint inhibitors: updated insights (Molecular Cancer, 2024)](https://link.springer.com/article/10.1186/s12943-024-02212-7)\n3. [Immune checkpoint therapy—current perspectives and future directions (Cell, 2023)](https://doi.org/10.1016/j.cell.2023.03.006)\n4. [Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced Melanoma (CheckMate 067)](https://www.nejm.org/doi/full/10.1056/NEJMoa2407417)\n5. [FDA Originator's Memorandum, BLA 125557 Blincyto (blinatumomab)](https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/125557Orig1s000ODMemo.pdf)\n6. [FDA Summary Basis for Regulatory Action, KYMRIAH (tisagenlecleucel), April 13, 2018](https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/April-13--2018-Summary-Basis-for-Regulatory-Action---KYMRIAH.pdf)\n7. [Kymriah (tisagenlecleucel) – An overview of the clinical development journey of the first approved CAR-T therapy](https://pmc.ncbi.nlm.nih.gov/articles/PMC10294746/)\n8. [Cancer therapy with antibodies](https://pmc.ncbi.nlm.nih.gov/articles/PMC11180426/)\n9. [Kymriah (tisagenlecleucel) EPAR Product Information, EMA](https://www.ema.europa.eu/en/documents/product-information/kymriah-epar-product-information_en.pdf)\n10. [Kantarjian et al., Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia (NEJM 2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC5881572/)\n11. [All about blinatumomab: the bispecific T cell engager immunotherapy for B cell acute lymphoblastic leukemia (2024)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11150604/)\n12. [Immunotherapy - StatPearls](https://www.ncbi.nlm.nih.gov/books/NBK519046/)\n13. [Leigh Marcus and colleagues (2019). FDA Approval Summary: Pembrolizumab for the Treatment of Microsatellite Instability-High Solid Tumors. Clinical Cancer Research.](https://doi.org/10.1158/1078-0432.ccr-18-4070)\n14. [CTLA-4 can function as a negative regulator of T cell activation (Immunity, 1994)](https://doi.org/10.1016/1074-7613%2894%2990071-x)\n15. [M F Krummel, J P Allison (1995). CD28 and CTLA-4 have opposing effects on the response of T cells to stimulation.. The Journal of Experimental Medicine.](https://doi.org/10.1084/jem.182.2.459)\n16. [Dana R. Leach, Matthew F. Krummel, James P. Allison (1996). Enhancement of Antitumor Immunity by CTLA-4 Blockade. Science.](https://doi.org/10.1126/science.271.5256.1734)\n17. [Y. Ishida and colleagues (1992). Induced expression of PD‐1, a novel member of the immunoglobulin gene superfamily, upon programmed cell death.. The EMBO Journal.](https://doi.org/10.1002/j.1460-2075.1992.tb05481.x)\n18. [Gordon J. Freeman and colleagues (2000). Engagement of the Pd-1 Immunoinhibitory Receptor by a Novel B7 Family Member Leads to Negative Regulation of Lymphocyte Activation. The Journal of Experimental Medicine.](https://doi.org/10.1084/jem.192.7.1027)\n19. [Yoshiko Iwai and colleagues (2002). Involvement of PD-L1 on tumor cells in the escape from host immune system and tumor immunotherapy by PD-L1 blockade. Proceedings of the National Academy of Sciences.](https://doi.org/10.1073/pnas.192461099)\n20. [Y. Iwai (2004). PD-1 blockade inhibits hematogenous spread of poorly immunogenic tumor cells by enhanced recruitment of effector T cells. International Immunology.](https://doi.org/10.1093/intimm/dxh194)\n21. [F. Stephen Hodi and colleagues (2010). Improved Survival with Ipilimumab in Patients with Metastatic Melanoma. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa1003466)\n22. [The 2018 Nobel Prize in Physiology or Medicine - Press release](https://www.nobelprize.org/prizes/medicine/2018/press-release/)\n23. [Caroline Robert and colleagues (2015). Pembrolizumab versus Ipilimumab in Advanced Melanoma. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa1503093)\n24. [James Larkin and colleagues (2015). Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa1504030)\n25. [Michael A. Postow and colleagues (2015). Nivolumab and Ipilimumab versus Ipilimumab in Untreated Melanoma. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa1414428)\n26. [A guide to cancer immunotherapy: from T cell basic science to clinical practice](https://pmc.ncbi.nlm.nih.gov/articles/PMC7238960/)\n27. [Diane Seimetz, Horst Lindhofer, Carsten Bokemeyer (2010). Development and approval of the trifunctional antibody catumaxomab (anti-EpCAM×anti-CD3) as a targeted cancer immunotherapy. Cancer Treatment Reviews.](https://doi.org/10.1016/j.ctrv.2010.03.001)\n28. [Amgen press release: FDA Approves BLINCYTO (blinatumomab), December 3, 2014](https://investors.amgen.com/news-releases/news-release-details/fda-approves-blincytotm-blinatumomab-immunotherapy-treatment)\n29. [Ralf Bargou and colleagues (2008). Tumor Regression in Cancer Patients by Very Low Doses of a T Cell–Engaging Antibody. Science.](https://doi.org/10.1126/science.1158545)\n30. [Max S. Topp and colleagues (2011). Targeted Therapy With the T-Cell–Engaging Antibody Blinatumomab of Chemotherapy-Refractory Minimal Residual Disease in B-Lineage Acute Lymphoblastic Leukemia Patients Results in High Response Rate and Prolonged Leukemia-Free Survival. Journal of Clinical Oncology.](https://doi.org/10.1200/jco.2010.32.7270)\n31. [Xinghua Pang and colleagues (2023). Cadonilimab, a tetravalent PD-1/CTLA-4 bispecific antibody with trans-binding and enhanced target binding avidity. mAbs.](https://doi.org/10.1080/19420862.2023.2180794)\n32. [Approved CAR-T therapies have reproducible efficacy and ...](https://pmc.ncbi.nlm.nih.gov/articles/PMC11305028/)\n33. [Hussein A. Tawbi and colleagues (2022). Relatlimab and Nivolumab versus Nivolumab in Untreated Advanced Melanoma. New England Journal of Medicine.](https://doi.org/10.1056/nejmoa2109970)\n34. [Pembrolizumab versus Chemotherapy for PD-L1–Positive Non–Small-Cell Lung Cancer (KEYNOTE-024)](https://www.nejm.org/doi/full/10.1056/NEJMoa1606774)\n35. [Overcoming cold tumors: a combination strategy of immune checkpoint inhibitors (Frontiers in Immunology, 2024)](https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1344272/full)\n36. [Combination of immune-checkpoint inhibitors and targeted therapies for melanoma therapy (Cancer Metastasis Reviews, 2023)](https://link.springer.com/article/10.1007/s10555-023-10097-z)\n\n---\n*Topic: Encyclopedia › Life and health › Human health and medicine › Medicines and therapeutics › Biologics, monoclonal antibodies, and biosimilars*\n\n*Initially written Sep 29, 2026 · Edited: Oct 15, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n",
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 "credit_md": "\"[Targeted immunotherapy](https://www.edgepedia.org/targeted-immunotherapy)\", Edgepedia (EdgeChat), [https://www.edgepedia.org/targeted-immunotherapy](https://www.edgepedia.org/targeted-immunotherapy). [Edgepedia Community License 1.0](https://www.edgepedia.org/edgepedia/license).",
 "credit_html": "\"<a href=\"https://www.edgepedia.org/targeted-immunotherapy\">Targeted immunotherapy</a>\", Edgepedia (EdgeChat), <a href=\"https://www.edgepedia.org/targeted-immunotherapy\">https://www.edgepedia.org/targeted-immunotherapy</a>. <a href=\"https://www.edgepedia.org/edgepedia/license\">Edgepedia Community License 1.0</a>.",
 "speakable": "Targeted immunotherapy is a cancer treatment category whose agents include immune checkpoint inhibitors, bispecific T-cell engagers, and CAR T-cell therapies, first approved in 2011 for melanoma."
}
