“Increasing the Effectiveness of Immune Checkpoint Inhibitors”
Featuring: Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS
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Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS
“Increasing the Effectiveness of Immune Checkpoint Inhibitors” (Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS ) [#147] Brad Power and Kayla Yup June 11, 2025 “We came to the realization that there are many potential interventions that we refer to as ‘financial orphans’, that are implementable today and for which there is no real unified advocate.
” – Vikas Sukhatme, MD, ScD “You are probably familiar with checkpoint blockade. This is clearly one of the biggest developments of the last 10 years or so. Durable responses have now been seen in many different solid tumor types. That's the good news. The bad news is these are very expensive, and there are serious immune related adverse events that do occur at fairly high frequency.
The efficacy typically ranges around 20% to 40% depending on tumor type, but for the most part, it's on the lower side of that number. The question that we asked ourselves is: ‘Can we do better? Can we do better now? Can we do better now with inexpensive treatments?’ And the answer I'd like to posit to you is ‘Possibly. Yes.
’” – Vikas Sukhatme, MD, ScD Meeting Summary Cancer patients and caregivers face challenges with immune checkpoint inhibitors. Immune checkpoint inhibitors are some of the most widely prescribed cancer drugs, representing over $40 billion in annual sales.
While immune checkpoint inhibitors have revolutionized the treatment of many cancers, a significant portion of patients do not respond -- roughly 20% to 40% respond. Increasing the effectiveness of immune checkpoint inhibitors can have significant impacts.
Vikas Sukhatme, MD, ScD, professor of medicine at Emory University and the founding director of the Morningside Center for Innovative and Affordable Medicine at Emory University , and his wife, Vidula Sukhatme, MS, co-founder and CEO of GlobalCures, are uniquely qualified to lead a discussion about complementary therapies that can increase the effectiveness of immune checkpoint inhibitors.
The Morningside Center was created to address the lack of financial incentives that inhibit the promotion of potentially effective and affordable medical treatments -- "financial orphans". Dr.
Sukhatme completed a bachelor's degree and then a doctorate (ScD) in theoretical physics at Massachusetts Institute of Technology, and he received an MD from Harvard Medical School in the Harvard-MIT program in Health Sciences and Technology. He spent two years at Stanford in immunology research. Vidula Sukhatme is an Instructor in the Rollins School of Public Health, Emory University.
She is a co-founder of the Morningside Center and is the founding CEO of GlobalCures, which searches published scientific papers to identify and prioritize generic existing drugs that could be repurposed for cancer use, as well as nutritional products and lifestyles that may be of value to cancer patients. How have immune checkpoint inhibitors revolutionized cancer treatment?
res, which searches published scientific papers to identify and prioritize generic existing drugs that could be repurposed for cancer use, as well as nutritional products and lifestyles that may be of value to cancer patients. How have immune checkpoint inhibitors revolutionized cancer treatment? Immune checkpoint inhibitors have been one of the biggest developments in cancer treatment in the last 10 years. They enable durable responses across multiple solid tumor types, which was
“Increasing the Effectiveness of Immune Checkpoint Inhibitors” (Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS ) [#147] not previously possible. However, their effectiveness is still limited - ranging typically from 20- 40% depending on tumor type, with most outcomes on the lower end of that range.
The key advantages are: ●Ability to create long-lasting immune responses against cancer ●Potential for treatment across different cancer types ●Mechanism of "unleashing" T-cell responses against tumors The main challenges remain: ●High cost ●Serious immune-related adverse events ●Relatively low overall efficacy rates Should you consider getting an immune checkpoint inhibitor?
Checkpoint inhibitors are most often used in advanced (metastatic) cancer settings and in specific cancer types where durable responses have been observed. There is also increasing usage prior to surgical removal of tumors. How might you increase the effectiveness of immune checkpoint inhibitors?
●Correct magnesium deficiencies ●Ensure adequate vitamin D levels ●Maintain a high-fiber diet (>20g/day) ●Time your infusions in the morning, if possible, at least for the first four infusions ●Delay immunotherapy 3-4 days after chemotherapy when both are being used concurrently ●Use antihistamines (specifically histamine 1 receptor blockers) if you have high histamine levels ●Correct vitamin deficiencies ●Avoid medications that might antagonize checkpoint inhibitors (steroids, antibiotics, proton pump inhibitors, histamine 2 receptor blockers, acetaminophen) ●Avoid off-the-shelf probiotics (but consider clostridium butyricum) How can you access these complementary therapies?
“Increasing the Effectiveness of Immune Checkpoint Inhibitors” (Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS ) [#147] How can you learn more about complementary therapies for immune checkpoint inhibitors? ●Visit the Morningside Center's website for ongoing research and information and join their patient cancer registry to contribute and learn about emerging therapies
, MD, ScD, and Vidula Sukhatme, MS ) [#147] How can you learn more about complementary therapies for immune checkpoint inhibitors?
●Visit the Morningside Center's website for ongoing research and information and join their patient cancer registry to contribute and learn about emerging therapies ●Consult with oncologists who are open to exploring complementary approaches ●Review the scientific literature ●If you are going to get immune checkpoint inhibitors, talk with your medical team about the complementary interventions discussed.
●Contact Vidula Sukhatme at Vidula@Global-cures.org or Vikas Sukhatme at vsukhatme@emory.
edu ●See other discussions that touch on complementary therapies and immune checkpoint inhibitors: ○"Personalized Cancer Vaccines" (Willy Hoos) [#29] ○“Update on Immunotherapies for Metastatic Castrate Resistant Prostate Cancer” (Sumit Subudhi) [#66] ○“Update on Prostate Cancer Treatments, Especially Radiopharmaceuticals” (Oliver Sartor, MD) [#122] ○“Finding Personalized Cancer Treatments Beyond the Standard through a Unique Test” (Travera) [#77] ○“How I Help Patients Access New Diagnostics” (Joanne Weidhaas, MD, PhD, MSM) [#138] The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.
You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. For the video recording of this conversation, please see here. For a transcript of the conversation, please see here. For the slides, please see here.
“Increasing the Effectiveness of Immune Checkpoint Inhibitors” (Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS ) [#147] Meeting Notes KEYWORDS Immune checkpoint inhibitors, complementary therapies, Morningside Center, financial orphans, cancer registry, magnesium deficiency, vitamin D, dietary fiber, histamine blockade, time of day effect, low dose chemotherapy, patient advocacy, clinical trials, repurposed drugs, cancer immunity cycle.
SPEAKERS Vikas Sukhatme (47%), Vidula Sukhatme (29%), Chris Apfel (9%), Roger Royse (7%), Richard Anders (4%), Allen Morris (2%), Russ Hollyer (2%) CHAT CONTRIBUTORS Richard Anders, Roger Royse, David Plunkett, Russ Hollyer, Rick Davis, Chris Apfel, Allen Morris, Vidula Sukhatme SUMMARY Vikas Sukhatme and Vidula Sukhatme discussed complementary therapies to enhance the effectiveness of immune checkpoint inhibitors (ICIs).
They highlighted the Morningside Center's efforts to create a database of financial orphans, focusing on optimizing dosing, scheduling, and efficacy.
hance the effectiveness of immune checkpoint inhibitors (ICIs). They highlighted the Morningside Center's efforts to create a database of financial orphans, focusing on optimizing dosing, scheduling, and efficacy. Key interventions include correcting magnesium and vitamin D deficiencies, using antihistamines, beta blockers, and delaying ICIs by 3-4 days post-chemo.
They presented data showing improved outcomes with early morning infusions and specific dietary interventions. The Sukhatmes emphasized the need for a national patient cancer registry to collect and analyze outcomes data, aiming to improve ICI efficacy and reduce adverse events.
OUTLINE Introductions and Overview of the Morningside Center ●Vikas Sukhatme introduced the Morningside Center's mission to bring new treatment options to patients, focusing on financial orphans like off-patent drugs, nutraceuticals, and lifestyle modifications.
●The center aims to create a clinical impact through a database of financial opportunities, sponsor trials, and create a cancer registry, with a focus on optimizing dosing and scheduling and increasing the efficacy of checkpoint blocking. ●The three major buckets of financial orphans are: off-patent FDA-approved drugs, nutraceuticals, and lifestyle modifications.
●Increasing the efficacy of checkpoint blocking is expensive and associated with serious immune-related adverse events. ●Various studies show the impact of magnesium, vitamin D, dietary fiber, histamine blockade, and time of day on the efficacy of checkpoint blocking.
“Increasing the Effectiveness of Immune Checkpoint Inhibitors” (Vikas Sukhatme, MD, ScD, and Vidula Sukhatme, MS ) [#147] ●Magnesium has a role in enhancing immunotherapy, according to a paper in Cell that outlines its mechanism. ●Patients with normal magnesium levels had better outcomes than those with hypomagnesemia.
●Vitamin D has a role in increasing PD-1 blockade efficacy, citing a paper in Melanoma. ●Data on dietary fiber intake show that patients with high fiber intake had better outcomes in a study from MD Anderson. Histamine Blockade and Time of Day Effects ●Histamine blockade improves checkpoint blockade efficacy, according to studies in non- small cell lung cancer.
●Data show that patients on H1 blockers had better outcomes than those on H2 blockers or without blockers. ●Morning infusions are better, according to a review paper showing a two- to threefold- effect on overall survival. ●Data from a randomized control trial show that early time of day infusions led to better progression-free survival and overall response rates.
Delaying Immunotherapy and Combination Studies ●Delaying immunotherapy is better for patients receiving concurrent therapy, according to animal data and a retrospective study. ●Data show that delaying immunotherapy led to a 50% increase in progression-free survival and disease control. ●Combining interventions is better.
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