Aaron C Tan1, Amy B Heimberger2, Mustafa Khasraw3. 1. Northern Sydney Cancer Centre, Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, 2065, Australia. 2. Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd., FC7.2000, Unit Number: 442, Houston, TX, 77030, USA. 3. NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, NSW, 1450, Australia. mustafa.khasraw@sydney.edu.au.
Abstract
PURPOSE OF REVIEW: Malignant gliomas result in disproportionately high morbidity and mortality compared with other primary tumors, and progression of disease is inevitable. Novel therapies to improve outcomes are needed and immune checkpoint inhibitors hold significant promise. RECENT FINDINGS: A limited body of preclinical evidence suggests that checkpoint inhibitors may be effective treatment for gliomas. Biomarkers to identify characteristics of gliomas responsive to these therapies will be essential. These may include mismatch repair deficiency and high mutational load that might be germline, somatic, or acquired after therapy. Evidence on the use of immune checkpoint inhibitors in gliomas is evolving. Clinical trials are underway and results are eagerly awaited. Understanding the role of immune checkpoint inhibitors in combination with other treatment modalities for gliomas is crucial to the improvement of outcomes. The design and conduct of future clinical trials need to account for increasingly complex treatment options.
PURPOSE OF REVIEW: Malignant gliomas result in disproportionately high morbidity and mortality compared with other primary tumors, and progression of disease is inevitable. Novel therapies to improve outcomes are needed and immune checkpoint inhibitors hold significant promise. RECENT FINDINGS: A limited body of preclinical evidence suggests that checkpoint inhibitors may be effective treatment for gliomas. Biomarkers to identify characteristics of gliomas responsive to these therapies will be essential. These may include mismatch repair deficiency and high mutational load that might be germline, somatic, or acquired after therapy. Evidence on the use of immune checkpoint inhibitors in gliomas is evolving. Clinical trials are underway and results are eagerly awaited. Understanding the role of immune checkpoint inhibitors in combination with other treatment modalities for gliomas is crucial to the improvement of outcomes. The design and conduct of future clinical trials need to account for increasingly complex treatment options.
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