Immunotherapy for brain metastases and primary brain tumors. (January 2023)

• Record Type: Journal Article
• Authors: Di Giacomo, Anna M.; Mair, Maximilian J.; Ceccarelli, Michele; Anichini, Andrea; Ibrahim, Ramy; Weller, Michael; Lahn, Michael; Eggermont, Alexander M.M.; Fox, Bernard; Maio, Michele
• Is Part Of: European journal of cancer. Volume 179(2023)
• Page Start: 113
• Page End: 120
• Publication Date: 2023-01
• Subjects: Immunotherapy -- Glioma -- Brain metastases -- Glioblastoma -- PD-1 -- PD-L1 -- CTLA-4 -- Biomarkers; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2022.11.012
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: During the V Siena Immuno-Oncology (IO) Think Tank meeting in 2021, conditions were discussed which favor immunotherapy responses in either primary or secondary brain malignancies. Core elements of these discussions have been reinforced by important publications in 2021 and 2022. In primary brain tumors (such as glioblastoma) current immunotherapies have failed to deliver meaningful clinical benefit. By contrast, brain metastases frequently respond to current immunotherapies. The main differences between both conditions seem to be related to intrinsic factors (e.g., type of driver mutations) and more importantly extrinsic factors, such as the blood brain barrier and immune suppressive microenvironment (e.g., T cell counts, functional differences in T cells, myeloid cells). Future therapeutic interventions may therefore focus on rebalancing the immune cell population in a way which enables the host to respond to current or future immunotherapies. Highlights: Immunotherapy of brain tumors was discussed at the V NIBIT Foundation I–O Think Tank. Unlike brain metastases primary brain tumors respond poorly to ICI therapies. The immune suppressive microenvironment contributes to failures of ICI therapy. Neo-adjuvant studies may provide insights to boost the efficacy of ICI therapy.