Pembro primed.

What’s totally in vogue for PD-1 axis inhibition? Ok, yeah, PET imaging. But also pembro has been trying to prove its worth as neoadjuvant therapy for resectable disease. The rationale is that there are more tumor antigens to recognize when the tumor is still, you know, there. This early-phase trial randomized 35 patients with resectable recurrent glioblastoma multiforme (GBM) to [1] adjuvant versus [2] neoadjuvant plus adjuvant pembrolizumab. Though the numbers are small, there was still a significant nearly doubling in median overall survival from 8 to 14 months with the neoadjuvant approach. What’s more, resected tumors had unique signatures following neoadjuvant pembro including upregulated PD-L1 expression. TBL: Neoadjuvant PD-1 axis inhibition prior to tumor resection may optimally prime tumor cells and host immunity for post-operative PD-1 axis blockade, which could mean good things for bad tumors like recurrent GBM. | Cloughesy, Nat Med 2019