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Immunotherapy and Response Assessment in Malignant Glioma: Neuro-oncology Perspective
Stephen J Bagley1,2, Arati S Desai1,2, MacLean P Nasrallah2,3
1Division of Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Abstract:
Glioblastoma (GBM) is the deadliest form of brain cancer and recurs uniformly. Despite aggressive treatment with maximal safe surgical resection, adjuvant radiation with temozolomide chemotherapy, and alternating electrical field therapy, median survival for newly diagnosed GBM remains <2 years. Novel therapies are desperately needed. Immunotherapy, which has led to significant improvement in patient outcomes across many tumor types, is currently being studied in a large number of GBM clinical trials. One of the biggest challenges in immunotherapy trials in GBM has been accurate response assessment using currently available imaging modalities, including magnetic resonance imaging. In this review, we will discuss the rationale for immunotherapy for GBM, immunotherapeutic modalities currently under clinical evaluation in GBM, and the challenges and recent advances in imaging response assessment in GBM immunotherapy.
Insights
Glioblastoma immunotherapy shows promise but accurate response assessment using imaging is challenging. Advances in magnetic resonance imaging are improving evaluation of novel brain cancer treatments.
Area of Science:
- Neuro-oncology
- Cancer Immunology
- Medical Imaging
Background:
- Glioblastoma (GBM) is an aggressive brain cancer with poor prognosis despite standard treatments.
- Novel therapeutic strategies, particularly immunotherapy, are under investigation for GBM.
- Accurate assessment of treatment response in GBM clinical trials remains a significant challenge.
Purpose of the Study:
- To review the rationale and current status of immunotherapy for GBM.
- To discuss various immunotherapeutic modalities being evaluated in GBM.
- To highlight challenges and recent advancements in imaging-based response assessment for GBM immunotherapy.
Main Methods:
- Literature review of preclinical and clinical studies on GBM immunotherapy.
- Analysis of current imaging techniques for response evaluation in GBM.
- Discussion of emerging imaging biomarkers and methodologies.
Main Results:
- Immunotherapy has shown potential in improving outcomes for various cancers.
- Several immunotherapy approaches are in clinical trials for GBM.
- Current imaging modalities like MRI face limitations in accurately assessing GBM immunotherapy response.
Conclusions:
- Immunotherapy represents a promising avenue for treating GBM.
- Overcoming challenges in imaging response assessment is crucial for successful GBM immunotherapy trials.
- Advances in medical imaging are vital for monitoring treatment efficacy and guiding clinical decisions in GBM.
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