Abstract:
Immune checkpoint inhibitors (ICIs) are a class of immunotherapy agents capable of
alleviating the immunosuppressive effects exerted by tumorigenic cells. The programmed cell
death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint is one of the most
ubiquitous checkpoints utilized by tumorigenic cells for immune evasion by inducing apoptosis
and inhibiting the proliferation and cytokine production of T lymphocytes. Currently, the most
frequently used ICIs targeting the PD-1/PD-L1 checkpoint include monoclonal antibodies (mAbs)
pembrolizumab and nivolumab that bind to PD-1 on T lymphocytes and inhibit interaction with PD-L1
on tumorigenic cells. However, pembrolizumab and nivolumab are costly, and thus their accessibility
is limited in low- and middle-income countries (LMICs). Therefore, it is essential to develop novel
biomanufacturing platforms capable of reducing the cost of these two therapies. Molecular farming
is one such platform utilizing plants for mAb production, and it has been demonstrated to be a
rapid, low-cost, and scalable platform that can be potentially implemented in LMICs to diminish the
exorbitant prices, ultimately leading to a significant reduction in cancer-related mortalities within
these countries.
