Neoadjuvant immunotherapy with surgical window for glioblastoma
Give immunotherapy before surgery rather than after, so the tumour is still present to teach the immune system, then look inside it to learn what happened.
A Nature Medicine 2019 study by Cloughesy and colleagues showed that neoadjuvant pembrolizumab in recurrent glioblastoma increased interferon signatures and T-cell clonal expansion and was associated with longer OS than adjuvant-only in a small randomised study, the only positive checkpoint signal in the disease. Window-of-opportunity designs (GESTALT, ASCO 2026) show feasibility.
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