Tiffany R Hodges1, Sherise D Ferguson1, Hillary G Caruso2, Gary Kohanbash3, Shouhao Zhou4, Timothy F Cloughesy5, Mitchel S Berger3, George H Poste6, Mustafa Khasraw7, Sujuan Ba8, Tao Jiang9, Tom Mikkelson10, W K Alfred Yung11, John F de Groot11, Howard Fine12, Lewis C Cantley13, Ingo K Mellinghoff14, Duane A Mitchell15, Hideho Okada3, Amy B Heimberger1. 1. Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center , Houston, TX, USA. 2. The Division of Pediatrics, The University of Texas M.D. Anderson Cancer Center , Houston, TX, USA. 3. Department of Neurosurgery, the University of California at San Francisco , San Francisco, USA. 4. Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center , Houston, TX, USA. 5. Department of Neuro-Oncology, the University of California at Los Angeles , Los Angeles, CA, USA. 6. Arizona State University , Scottsdale, AZ, USA. 7. The University of Sydney , NSW 2006 , Sydney, Australia. 8. The National Foundation for Cancer Research, Bethesda, MD, USA, Asian Fund for Cancer Research , Hong Kong, People's Republic of China. 9. Department of Neurosurgery, Tiantan Hospital, Capital Medical University , Beijing, China. 10. Department of Neurosurgery, Henry Ford Health System , Detroit, MI, USA. 11. Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center , Houston, TX, USA. 12. Division of Neuro-Oncology, Weill Cornell Medical College , New York, NY, USA. 13. Department of Systems Biology, Harvard Medical School , Boston, MA, USA. 14. Department of Neurology and Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center , New York, NY, USA. 15. Department of Neurosurgery, University of Florida , Gainesville, FL, USA.
Abstract
BACKGROUND: Emerging immunotherapeutic strategies for the treatment of glioblastoma (GBM) such as dendritic cell (DC) vaccines, heat shock proteins, peptide vaccines, and adoptive T-cell therapeutics, to name a few, have transitioned from the bench to clinical trials. With upcoming strategies and developing therapeutics, it is challenging to critically evaluate the practical, clinical potential of individual approaches and to advise patients on the most promising clinical trials. METHODS: The authors propose a system to prioritize such therapies in an organized and data-driven fashion. This schema is based on four categories of factors: antigenic target robustness, immune-activation and -effector responses, preclinical vetting, and early evidence of clinical response. Each of these categories is subdivided to focus on the most salient elements for developing a successful immunotherapeutic approach for GBM, and a numerical score is generated. RESULTS: The Score Card reveals therapeutics that have the most robust data to support their use, provides a reference prioritization score, and can be applied in a reiterative fashion with emerging data. CONCLUSIONS: The authors hope that this schema will give physicians an evidence-based and rational framework to make the best referral decisions to better guide and serve this patient population.
BACKGROUND: Emerging immunotherapeutic strategies for the treatment of glioblastoma (GBM) such as dendritic cell (DC) vaccines, heat shock proteins, peptide vaccines, and adoptive T-cell therapeutics, to name a few, have transitioned from the bench to clinical trials. With upcoming strategies and developing therapeutics, it is challenging to critically evaluate the practical, clinical potential of individual approaches and to advise patients on the most promising clinical trials. METHODS: The authors propose a system to prioritize such therapies in an organized and data-driven fashion. This schema is based on four categories of factors: antigenic target robustness, immune-activation and -effector responses, preclinical vetting, and early evidence of clinical response. Each of these categories is subdivided to focus on the most salient elements for developing a successful immunotherapeutic approach for GBM, and a numerical score is generated. RESULTS: The Score Card reveals therapeutics that have the most robust data to support their use, provides a reference prioritization score, and can be applied in a reiterative fashion with emerging data. CONCLUSIONS: The authors hope that this schema will give physicians an evidence-based and rational framework to make the best referral decisions to better guide and serve this patient population.
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