If you’re a parent, then there have been those moments we can all relate to when you’ve just pulled onto the freeway and your young children in the back start asking, “Are we there yet?”

This must be the question a lot of clinical oncologists are asking themselves these days. The American Society of Clinical Oncologists (ASCO) met in May in Chicago and some of the clinical trials presented were simply ground breaking with regards to the treatment of cancers across the board.

One of the headline studies was that of the combination dual therapy of ipilimumab (a CTLA-4 checkpoint inhibitor) and nivolumab (a PD-L1 checkpoint inhibitor) in patients with advanced—Stage III and Stage IV—melanoma, one of the most serious forms of cancer that kills over 2,000 people in the UK each year, is expected to kill 10,000 people in the U.S. in 2015 and globally one person will die every hour. The Checkmate 067 trial investigated the effect of ipilimumab alone, nivolumab alone and a combination therapy of the two drugs in patients with advanced skin cancer. Out of nearly 1,000 patients treated (n=945) in the combination arm of the study, almost 60% illustrated no progression of the cancer in a year, and either stopped or shrank the malignant tumors. Compared to the patients treated with single therapy these results were highly impressive.

At the same time a separate trial was presented illustrating that nivolumab alone could improve survival in lung cancer patients for an average of 12.2 months compared to 9.4 months on standard therapy. In some cases this was extended to 19.4 months. Lung cancer kills almost 2 million people each year and is often difficult to diagnose until other symptoms occur and often not suitable for removal by surgery. The PD-L1 monoclonal antibody, in very simple terms, assists the immune system in responding to the presence of malignant tumors and prevents the negative actions of the PD-L1 protein. A number of these checkpoint inhibitors are in development from various pharmaceutical companies, but in lung cancer it seems to be particularly effective, potentially doubling life expectancy in some patients.

Immunotherapy was the buzzword of the events at ASCO. Another key study presented data that shows that pembrolizumab may be effective in patients that have metastatic head and neck cancer (HNC). In the study of 132 patients 57% showed some tumor shrinkage and almost 25% illustrated a marked decrease in tumor size. Current treatments tend to incorporate EDFR-inhibitors and it is suggested that pembrolizumab could be almost twice as effective across a range of different HNC tumors.

Another key study presented at the conference was that the PALOMA-3 trial, which demonstrated the use of palbociclib in combination with HRT (fulvestrant) to treat previously treated, non-responsive breast cancer. The trial demonstrated that the treatment delayed disease progression by almost 5 months in patients that had previously treated hormone receptor-positive, human epidermal growth factor receptor 2 negative  (HR/HER2-) advanced breast cancer. Palbociclib is a first in class cylcin dependent kinase 4 and 6 selective inhibitor and it is hoped that it will proved an alternative treatment option to chemotherapy which is often a difficult to tolerate treatment option which follows active hormone therapy in metastatic breast cancer.

Lenvatinib studies were presented considering its use in combination with everolimus and with each treatment alone in metastatic renal cell carcinoma (mRCC). The results for dual therapy illustrated a progression free survival of a median of 14.6 months compared with 5.5 months in those who received everolimus alone.

Many of the trials presented have illustrated extended use of currently licensed drugs as well as considering their use in combination therapy. Immunotherapy in cancer is definitely taking a hold and certainly there has been an air of excitement since the results were made public several weeks ago at ASCO. The question seems to be, “Is this going to be the cure?”

Immunotherapy effectively prevents cancerous cells from inhibiting our natural defenses against misbehaving cells—cancer cells introduce a ‘mask’ to our inborn ability to destroy cells that are effectively wreaking havoc and the immunotherapy drugs have come along to ruin their party. The only thing is that researchers and medics simply don’t know the answer. Not all patients respond well to the newly available types of drug, and it’s not completely understood if all tumors will respond.

Most of the research that has been conducted in this area is based around lung and skin cancer with only very embryonic level research outside of this. Although this is incredibly significant and highly important there are many other types of solid and haematological malignancies that could be investigated. The other factor is that treatment options for patients are dependent on licenses being granted by regulatory authorities, availability across continents and as always it comes down to the dollars in the coffers.