# Fluorinated small molecule derivatives in cancer immunotherapy: emerging frontiers and therapeutic potential

**Authors:** Ka Fai Leong, Zihan Chen, Paolo Coghi

PMC · DOI: 10.3389/fimmu.2025.1622091 · Frontiers in Immunology · 2025-07-18

## TL;DR

This paper explores how adding fluorine to small molecules can improve cancer immunotherapy by enhancing drug properties and targeting immune pathways.

## Contribution

The paper highlights the novel use of fluorinated small molecules to modulate immune pathways in cancer treatment.

## Key findings

- Fluorinated small molecules show improved pharmacokinetics and oral bioavailability for immunotherapy.
- They target immune checkpoints, STING agonists, IDO inhibitors, and kinase pathways effectively.
- Challenges like immunotoxicity and resistance are discussed with potential design strategies to address them.

## Abstract

Immunotherapy has revolutionized cancer treatment by leveraging the body’s immune system to recognize and eliminate tumor cells. While monoclonal antibodies and checkpoint inhibitors have shown dramatic clinical successes, small molecules are increasingly recognized for their potential to modulate the immune system with improved pharmacokinetics and oral bioavailability. The incorporation of fluorine atoms into small molecule structures has become a widely used strategy to enhance therapeutic efficacy. Fluorine’s unique chemical properties such as high electronegativity, metabolic stability, and ability to modulate lipophilicity make fluorinated small molecules especially attractive for immunotherapeutic applications. This minireview highlights recent advances in fluorinated small molecules that target key immune pathways, including immune checkpoints, STING agonists, IDO inhibitors, and kinase pathways involved in immune regulation. We explore the chemical rationale, mechanisms of action, and therapeutic outcomes of fluorinated compounds currently in preclinical and clinical development. The discussion also addresses challenges such as immunotoxicity, resistance, and design strategies to overcome them. Together, these findings underscore the growing relevance of fluorinated small molecule immunotherapeutics in cancer treatment.

## Linked entities

- **Chemicals:** fluorine (PubChem CID 24524)
- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Genes:** IDO1 (indoleamine 2,3-dioxygenase 1) [NCBI Gene 3620] {aka IDO, IDO-1, INDO}, STING1 (stimulator of interferon response cGAMP interactor 1) [NCBI Gene 340061] {aka ERIS, MITA, MPYS, NET23, SAVI, STING}
- **Diseases:** cancer (MESH:D009369)
- **Chemicals:** Fluorine (MESH:D005461)

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12313516/full.md

## References

182 references — full list in the complete paper: https://tomesphere.com/paper/PMC12313516/full.md

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Source: https://tomesphere.com/paper/PMC12313516