Lower Dose, Less Frequent Immunotherapy Shows Promise for Cancer Treatment

A new clinical trial is investigating whether a reduced dose and less frequent administration of the immunotherapy drug nivolumab can make this life-extending treatment more accessible and affordable, particularly for patients in low- and middle-income countries. The study, led by researchers at Fred Hutchinson Cancer Center, aims to address the significant financial barriers that currently limit access to this revolutionary cancer therapy.

The Promise of Immunotherapy

Immunotherapy, specifically immune checkpoint inhibitors like nivolumab, has dramatically improved survival rates for many types of cancer. According to research, a stage 4 melanoma diagnosis once carried a prognosis of approximately eight months. With the advent of these drugs, survival has been extended to five years . These drugs work by releasing brakes on the immune system, allowing it to recognize and attack cancer cells.

The Cost Barrier

Despite its effectiveness, the high cost of immunotherapy poses a major challenge. The expense is unsustainable in the United States and prohibitive for many patients in resource-limited settings. This new trial seeks to address this issue by exploring a more cost-effective treatment regimen.

The Clinical Trial: Combining Lower Dose and Reduced Frequency

The Phase 2 clinical trial, co-led by Shailender Bhatia, MD, director of the Melanoma and Renal Cancer Team at Fred Hutch and Dr. Tachiki, will test a markedly lower dose of nivolumab administered less frequently. Previous research by Tachiki and Bhatia has indicated that both reduced frequency and lower doses of nivolumab can still be effective, either in patients who respond well to standard regimens or to minimize side effects .

The study is unique in its approach, combining both principles – lower dose and reduced frequency – while utilizing immunotherapy alone, without chemotherapy, to minimize side effects for patients. Researchers estimate this approach could reduce the cost of nivolumab by 100-fold .

Expanding Access to Treatment

The trial will include patients in Uganda who may not have access to effective cancer treatments otherwise. This initiative aligns with the Kuni Foundation’s commitment to funding innovative cancer research that improves accessibility to clinical trials for underserved communities . The study is funded by a $1.05 million Kuni Foundation Discovery Grant.

The Role of Unrestricted Funding

The Kuni Foundation’s unrestricted award provides researchers with the flexibility to pursue promising ideas that might not otherwise be funded. This support allows Dr. Tachiki to develop research concepts and prepare grant applications, particularly for research that isn’t necessarily revenue-generating for pharmaceutical companies .

Nivolumab in Merkel Cell Carcinoma

Nivolumab, with or without ipilimumab, has also shown promising results in treating Merkel cell carcinoma (MCC). A study published in March 2025 found objective response rates of 60% with nivolumab monotherapy and 58% with nivolumab plus ipilimumab in patients with advanced MCC . However, the combination therapy did not demonstrate improved efficacy in this study.

Looking Ahead

If successful, this research could significantly expand access to life-saving immunotherapy for cancer patients worldwide, reducing both financial burdens and treatment-related side effects. Fred Hutch Cancer Center continues to be at the forefront of clinical trials for checkpoint inhibitors, driven by the belief that the immune system holds the key to eradicating cancer cells .