Monoclonal antibodies are effective when used in combination, including yervoy and opdivo - both BMY mAbs - and they demonstrate greater efficacy than either one used alone, but they are simply too expensive to produce. Moreover, their safety profiles aren't particularly all that encouraging when they are applied systemically together at the current dose regimens.
All monoclonal antibodies need to come down in price. A combination anti-ctla-4 and anti-pd-1 treatment would likely cost over $250k per patient per year. No company is ever going to achieve significant market share priced like that.
One solution to this problem is to have your body manufacture the antibodies in vivo, either in muscle cells or intratumorally. Both applications should theoretically work. DNA encoded antibodies are reportedly MUCH more scalable and they would require far fewer injections than lab produced mAbs like opdivo, yervoy, keytruda, etc. Improved safety and cost seem like a paradigm shift to me if efficacy is equivalent or better.
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