Introduction
toxicity, cancer, cancers, melanoma
NON-SMALL CELL LUNG CANCER, CANCERS, CANCER PROGRESSION, MELANOMA, CANCER, METASTATIC CANCER
Immune checkpoint inhibitors (ICI) have revolutionised cancer treatment over the last decade, resulting in durable responses and long-term survival in several cancer types [Despite their success, ICI impose a significant burden on patients and healthcare systems. ICI are routinely administered on a continuous schedule of frequent intravenous administrations (currently every 2–6 weeks) until cancer progression or the development of unacceptable toxicity. This approach requires a major commitment of resources for individual patients and health services alike. Disappointingly, due to the financial burden associated with treatment, ICI are not available globally to many who might benefit [At present, there is limited understanding around predictive biomarkers for initial use or continued treatment with ICI, resulting in significant over treatment [Physiological efficacy of ICI (measured by PD-1 T cell receptor occupancy) is observed at much lower doses than those that have become standard of care (SOC) [A number of clinical trials are currently testing early cessation in patients experiencing clinical response, either at a pre-determined timepoint such as 1 year (DANTE in melanoma or SAVE in non-small cell lung cancer [REFINE (REduced Frequency ImmuNE checkpoint inhibition in cancers) is a clinical trial using a multistage approach to test whether it is possible to extend the interval between treatments in patients with metastatic cancer that are responding to ICI treatment without significantly losing efficacy [