Reevaluation of the Frequent Use of PD-1 Checkpoint Inhibitors for Treatment of Glioblastoma

Mené sur 369 patients atteints d’un glioblastome récidivant, cet essai de phase III compare l’efficacité, du point de vue de la survie globale, et la toxicité du nivolumab et du bévacizumab (durée médiane de suivi : 9,5 mois)

Résumé en anglais

Glioblastoma is the most common malignant primary brain tumor in adults and affects approximately 3 per 100?000 persons in the US annually.1 The standard of care is surgical resection followed by radiotherapy and chemotherapy. This combination has been used since 1978 and was updated to include temozolomide in 2005, which modestly increased median overall survival from 12.1 to 14.6 months2 and increased 5-year survival from 2% to 10%.3 Most patients with glioblastoma experience disease progression, and the average survival is less than 9 months after relapse. Since 2005, many new drugs have been approved for cancer and have changed the care and prognosis for patients with other solid tumors. This includes the addition of 7 checkpoint inhibitors as both monotherapy and combination therapy for 14 cancer types following the approval of ipilimumab in 2011. The success of these drugs has led to great optimism in the neuro-oncologic community, and several immune therapeutics have been developed and tested, including a variety of tumor-specific vaccines, dendritic cell therapy, viral therapy, and immune checkpoint blockade. However, the results thus far have failed to demonstrate major benefit, and none has substantially improved survival for glioblastoma, leading to repeated disappointment for patients, their families, and the physicians who treat them. (…)