1. Academic Validation
  2. Immunotherapy for brain metastases and primary brain tumors

Immunotherapy for brain metastases and primary brain tumors

  • Eur J Cancer. 2023 Jan;179:113-120. doi: 10.1016/j.ejca.2022.11.012.
Anna M Di Giacomo 1 Maximilian J Mair 2 Michele Ceccarelli 3 Andrea Anichini 4 Ramy Ibrahim 5 Michael Weller 6 Michael Lahn 7 Alexander M M Eggermont 8 Bernard Fox 9 Michele Maio 10
Affiliations

Affiliations

  • 1 University of Siena and Center for Immuno-Oncology, University Hospital of Siena, V. le Bracci, 16, Siena, Italy. Electronic address: [email protected].
  • 2 Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. Electronic address: [email protected].
  • 3 University of Naples "Federico II", Naples, Italy. Electronic address: [email protected].
  • 4 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: [email protected].
  • 5 Parker Institute for Cancer Immunotherapy, 1 Letterman Drive, D3500, San Francisco, CA, USA. Electronic address: [email protected].
  • 6 Department of Neurology and Brain Tumor Center, University Hospital and University of Zurich, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland. Electronic address: [email protected].
  • 7 IOnctura SA, Avenue Secheron 15, Geneva, Switzerland. Electronic address: [email protected].
  • 8 Comprehensive Cancer Center München of the Technical University München and the Maximilian University, München, Germany; Princess Máxima Center and the University Medical Center Utrecht, Heidelberglaan 25, 3584 Utrecht, the Netherlands. Electronic address: [email protected].
  • 9 Earle A. Chiles Research Institute at the Robert W. Franz Cancer Center, 4805 NE Glisan St. Suite 2N35 Portland, OR 97213, USA. Electronic address: [email protected].
  • 10 University of Siena and Center for Immuno-Oncology, University Hospital of Siena, V. le Bracci, 16, Siena, Italy. Electronic address: [email protected].
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.

Keywords

Biomarkers; Brain metastases; CTLA-4; Glioblastoma; Glioma; Immunotherapy; PD-1; PD-L1.

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