Cancer Chemotherapy and Pharmacology

, Volume 83, Issue 5, pp 1003–1005 | Cite as

The clinical added value of the addition of anti-CTL-4 to anti-PD-1 alone is questionable and clearly increasing toxicity regarding pivotal studies in the treatment of melanoma and renal carcinoma

  • Nicolas AlbinEmail author
  • Adrien Monard
  • Jérémy Lapiere
Letter to the Editor

Dear Editor,

In recent years, we have witnessed undeniable progress in the treatment of cancer, leading to increased survival of metastatic patients as part of what is considered an incremental progress. The advances that have contributed to it include the development of immunotherapies, like anti-PD-1 and anti-CTL-4 treatments, and the introduction of tyrosine kinase inhibitors (TKi) [1].

Combining drugs of the same class or of different therapeutic classes is a classic strategy in the development of chemotherapy regimens and is recognized in various recommendations. However, we should carefully examine the robustness of evidence, in particular when the combined regimen is associated with a clearly demonstrated increase in toxicity, as is the case for the anti-PD-1/anti-CTL-4 immunotherapy combination [2].

Even though there is a pre-clinical rationale for combining anti-PD-1 and anti-CTL-4 therapeutics [3], the interest of introducing such a combination into clinical practice has to...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Groupe Hospitalier Mutualiste de Grenoble-Institut Daniel HollardGrenoble Cedex 1France

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