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VIDEO: Immune-based therapies ‘rapidly changing’ treatment paradigm for brain metastases
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Manmeet Ahluwalia, MD, director of the Brain Metastases Research Program at the Cleveland Clinic and neuro-oncology section editor for HemOnc Today, discusses the promise of immune-based therapies in patients diagnosed with brain metastases.
“Traditionally, the treatment of brain metastases mostly encompassed surgical-based approaches as well as radiation-based approaches,” he said. “The role of chemotherapy was limited in these patients. However, with the advent of immune-based therapies, this is rapidly changing.”
Several initial trials have indicated that monoclonal antibodies directed against CTLA-4 and PD-1 show responses in the brain, according to Ahluwalia.
He highlights research by Kim Margolin, MD, of City of Hope Comprehensive Cancer Center in Duarte, Calif., and colleagues looking at the anti-CTLA-4 ipilimumab (Yervoy, Bristol-Myers Squibb) “showing the initial dogma that the central nervous system was immune privilege site is not true.” He also points to promising results on the anti–PD-1 pembrolizumab (Keytruda, Merck) from investigators at Yale.
Ahluwalia also mentions that there are several trials currently ongoing or being launched combining immune checkpoint blockades with radiosurgery-based approaches.
“Stay tuned to the results of these trials, as this may show for the first time, the role of … immune-based therapies in treatment of patients with brain metastases,” he said.