Immune checkpoint inhibitors (ICIs) have revolutionised oncology, opening new possibilities for cancer treatment through immunotherapy. These monoclonal antibodies block proteins that would otherwise prevent the immune system from attacking cancer cells. The most well-known in this class are PD-1 and PD-L1 inhibitors. Their versatility has led to approval for a wide range of cancers, with a robust and promising pipeline of new ICIs. The WHO EML Committee has recognised their therapeutic value by including certain ICIs for the treatment of cutaneous melanoma, underscoring their effectiveness and potential for broader application.

Notably, ICIs have shown promise in addressing some of the most pressing global cancer challenges, including breast and cervical cancers—the most commonly diagnosed and deadliest cancers among women in LMICs. Among people living with HIV, many cancers occur more frequently due to infectious origins, such as Kaposi’s sarcoma (linked to human herpesvirus 8), non-Hodgkin lymphoma (linked to Epstein–Barr virus), and cervical cancer (linked to human papillomavirus, HPV) . People living with HIV who are on antiretroviral therapy and virally suppressed can live longer, managing HIV as a chronic condition, and face similar health issues as the general population. As a result, cancer has emerged as a leading cause of death in this population, posing new clinical challenges. Despite the paucity of safety and efficacy data of ICIs in the HIV population, emerging studies suggest that ICIs treatments do not interfere with HIV management, reinforcing the value of these therapies for this population.

However, ensuring broad access to ICIs remains a challenge. Recognising this, the WHO EML Committee has recommended further efforts to improve the affordability of ICIs, including consideration of voluntary licensing through MPP. In addition to voluntary licensing of intellectual property, MPP’s support for hands-on technology transfer could help accelerate development and lower the costs of quality-assured biosimilar versions of ICIs for use in LMICs. In line with this, MPP has strategically prioritised ICIs as a class, with pembrolizumab, approved for 18 types of cancer, including certain early-stage and advanced cancers, identified as a flagship product for this class.

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