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David A. Reardon, MD, clinical director, Center for Neuro-Oncology, institute physician, Dana-Farber Cancer Institute, and professor of medicine, Harvard Medical School, discusses the immunogenicity of glioblastoma.
David A. Reardon, MD, clinical director, Center for Neuro-Oncology, institute physician, Dana-Farber Cancer Institute, and professor of medicine, Harvard Medical School, discusses the immunogenicity of glioblastoma.
A phase II study of pembrolizumab (Keytruda) or pembrolizumab plus bevacizumab (Avastin) in recurrent glioblastoma, led by Reardon and colleagues, showed modest activity, leading researchers to believe that glioblastoma is mildly immunogenic. It is now known that certain tumor characteristics, including tumor mutational burden as well as the degree of inherent immune infiltrate, may lend insight into the likelihood of that tumor to respond to immunotherapy, explains Reardon.
This also lends insight into future research efforts, he says. Knowing this, researchers can work to modify an already mildly immunogenic tumor with a limited reserve of T cells. By bringing immune effector T cells into the tumor microenvironment, researchers may be able to manipulate a suppressive environment and bring about a response. It is a complex field to navigate, says Reardon, one that will require additional research efforts.