Immune checkpoint inhibitors in malignancy.

Immune checkpoints normally stop the body from mounting an immune response against healthy cells. Some cancers can acquire these checkpoints so that the tumour cells are not recognised by the immune system Inhibiting the checkpoints therefore enables the tumour cells to be recognised and allows an immune response to be activated against them Immune checkpoint inhibitors can improve the survival of some patients with advanced malignancies. These include malignant melanoma, renal cell carcinoma, urothelial bladder cancer and non-small cell lung cancer Trials have shown that immune checkpoint inhibitors have significant benefits over conventional therapies so they are increasingly being used in routine clinical practice However, a significant proportion of patients will not respond to immune checkpoint inhibitors and retain a poor prognosis. The optimal use of these drugs requires further study Immune-related adverse events commonly include pneumonitis, hepatitis, nephritis, colitis and endocrinopathies. However, nearly any organ system can be affected. These toxicities present clinicians with a new challenge of recognising them early and acting promptly