Immune checkpoint blockade therapy in high-grade glioma
Glioblastoma (GBM) is the most common primary brain cancer in adults and remains universally lethal. Despite extensive medical intervention, the median survival remains a bleak 15-17 months from time of diagnosis, calling for new therapeutic strategies. In recent years, immune checkpoint blockade (ICB) has garnered attention for its clinical successes in extending overall survival in many advanced-stage cancers. To date, ICB clinical trials have failed to proffer the same benefit in GBM patients, turning attention in the field toward understanding this shortcoming and employing new strategies. Genomic characteristics such as mutational burden, immunogenicity, and heterogeneity, along with immune infiltrate, CNS location, and immunosuppression (tumor-induced or iatrogenic), have been identified as critical components of ICB responsiveness. Promising results from recent clinical trials have rewarded efforts to understand the features of successful ICB and to restore enthusiasm for ICB as an encouraging therapeutic in the treatment of GBM.
