KEY TAKEAWAYS
- The study aimed to evaluate the efficacy and safety of various immunotherapies in HGG treatment.
- Results showed that immunotherapy, particulary DCV, holds promise for HGG, but varied results necessitate further RCTs.
High-grade gliomas (HGG), a type of brain cancer, represent a significant challenge in oncology, with conventional treatments often proving ineffective. Immunotherapy has emerged as a potentially powerful strategy due to its ability to trigger a targeted immune response against tumor cells.
Lucca B. Palavani and the team aimed to evaluate the efficacy and safety of various immunotherapeutic approaches in treating HGG, including immune checkpoint inhibitors (ICI), virotherapy, and dendritic cell vaccines (DCV).
Researchers conducted a comprehensive literature search using the PRISMA framework, examining studies from PubMed, Cochrane, and Embase databases. The analysis focused on studies reporting outcomes of patients with HGG treated with immunotherapy. Key metrics included overall survival (OS), progression-free survival (PFS), and treatment-related adverse events (TRAEs).
The meta-analysis included 47 studies including data from 3674 patients with HGG treated with immunotherapy. The results revealed a mean overall survival of 11.05 months for patients treated with ICI, 11.79 months for those receiving virotherapy, and a significantly longer 24.11 months for those treated with DCV.
Mean PFS for ICIs was 3.65 months. Virotherapy demonstrated a PFS favouring the control group, suggesting minimal impact, while DCV showed substantial PFS improvement with a median HR of 0.43 compared to controls (95% CI: 29–64%).
Adverse events were primarily Grade 1 or 2 for ICI and DCV, indicating a favourable safety profile. Virotherapy, however, was associated with a Grade 5 adverse event in one instance.
The meta-analysis suggested that immunotherapy, especially DCV, holds significant promise as an effective treatment modality for HGG. However, the efficacy of immunotherapy varies considerably depending on the specific type of therapy employed and individual patient profiles. To establish robust clinical guidelines and optimise treatment protocols, further large-scale, randomised controlled trials are warranted.
No funding support was provided.
Source: https://link.springer.com/article/10.1007/s11060-024-04813-0
Palavani LB, Mitre LP, Camerotte R, et al. (2024). “Advancements and challenges: immunotherapy in high-grade glioma—a meta-analysis of randomized clinical trials.” J Neurooncol. 2024. doi:10.1007/s11060-024-04813-0.
