THE ROLE OF IMMUNOTHERAPY IN CANCER TREATMENT: A COMPARATIVE STUDY OF PD-1 INHIBITORS AND CAR-T CELL THERAPY

Abstract

Immunotherapy has revolutionized oncology by harnessing the body's immune system to combat cancer. This comparative study evaluates the efficacy, safety, and clinical applicability of two pivotal immunotherapeutic approaches: immune checkpoint inhibitors (specifically PD-1 inhibitors) and adoptive cell therapy (Chimeric Antigen Receptor T-cell therapy, or CAR-T). We conducted a quantitative, problem-based analysis of clinical trial data and real-world evidence from 2018 to 2023. Our findings indicate that while both modalities significantly improve outcomes in specific malignancies, their profiles differ markedly. PD-1 inhibitors, such as pembrolizumab and nivolumab, demonstrate broad applicability across solid tumors like melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma, with objective response rates (ORR) ranging from 20-45%. Their primary limitations include immune-related adverse events (irAEs) and acquired resistance. In contrast, CAR-T cell therapy achieves remarkable efficacy in certain hematological cancers, notably B-cell acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL), with complete response rates reaching 40-90%. However, CAR-T therapy is constrained by severe toxicities like cytokine release syndrome (CRS) and neurotoxicity, complex manufacturing, and high cost. This study underscores the paradigm shift towards personalized immunotherapy, where treatment selection is increasingly dictated by tumor type, biomarker status (e.g., PD-L1 expression, tumor mutational burden), and patient-specific factors. The future of cancer therapy likely lies in rational combinations and next-generation engineered therapies designed to overcome current limitations.