The Evolving Role of Immunotherapy in Primary and Metastatic Brain Cancer

Primary brain tumors, particularly glioblastoma, represent a significant challenge in oncology. Although immunotherapies have revolutionized the treatment of other cancers, such as metastatic melanoma and certain lung cancers, their application to brain tumors has historically been less successful.

Nicholas Blondin, MD, associate professor of clinical neurology at Yale School of Medicine, spoke with CancerNetwork® about the evolving role of immunotherapy in the treatment of primary and metastatic brain cancer.

Blondin highlighted the limited efficacy of traditional immunotherapy approaches in glioblastoma, such as PD-1 inhibition. Chimeric antigen receptor (CAR) T-cell therapy is another evolving treatment approach in this field.

Blondin also discussed the early clinical trial data related to CAR T-cell therapy, shedding light on the efficacy and safety profile of this novel treatment modality. He also addressed the future directions of research in this area, including strategies to optimize CAR T-cell design and overcome the unique challenges posed by the tumor microenvironment in the brain.

Transcript:

Primary brain tumors—in particular, glioblastoma—are the most common malignant tumors in adults. Immunotherapies have generally been unsuccessful to date. There have been exciting advances in immunotherapy and other cancer types, particularly metastatic melanoma and some forms of lung cancer and urological cancer. For glioblastoma, these immunotherapy strategies, such as PD-1 inhibition, have generally been ineffective. However, a new immunotherapy approach called CAR [T-cell therapy] is being developed at several centers around the US…. It’s a form of a T cell, an important cell in the immune system, that can be designed through scientific methods to specifically target cancer cells and eradicate them. This therapy is still in its early days. CAR [T-cell therapy] treatments are now FDA approved for the treatment of [different] forms of lymphoma, multiple myeloma, and types of blood cancers, and there’s an early development for brain cancer. There appear to be promising results in these early studies.