Evidence map›Paper›PMID 32813186›Full record

ReviewJournal of neuro-oncology2021

Temozolomide treatment outcomes and immunotherapy efficacy in brain tumor.

Kelly M Hotchkiss, John H Sampson

Open access · greenAbstract readReview
In one paragraph

Review in Journal of neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Kelly M HotchkissDuke University, Durham, NC, USA.
John H SampsonDuke University, Durham, NC, USA. john.sampson@duke.edu.ORCID http://orcid.org/0000-0002-0104-7658
Duke University · US

Funding

Targeted Alpha-Particle Radiotheraphy of Brain Tumors with 211At-81C6 AntibodyP50CA190991 · NCI · DUKE UNIVERSITY · PI SAMPSON, JOHN H. · 2014 to 2023
$20.8M
Project 3: Phase-2 Trial of Oncolytic Poliovirus (PVSRIPO) combined with CCNU (lomustine) against Recurrent GlioblastomaP01CA225622 · NCI · DUKE UNIVERSITY · PI WEINHOLD, KENT J. · 2018 to 2022
$12.2M
Clinical Brain Tumor Development of a Cytomegalovirus-targeted Therapeutic with Vaccine pre-conditioning to Validate Novel Predictors of Vaccine EfficacyR01CA235612 · NCI · DUKE UNIVERSITY · PI SAMPSON, JOHN H. · 2019 to 2022
$2.0M
NCI NIH HHS P01 CA225622NCI NIH HHS P50 CA190991NCI NIH HHS R01 CA235612
6 · The paper itself

Abstract

introductionGlioblastoma (GBM) has a survival rate of around 2 years with aggressive current standard of care. While other tumors have responded favorably to trials combining immunotherapy and chemotherapy, GBM remains uniformly deadly with minimal increases in overall survival. GBM differ from others due to being isolated behind the blood brain barrier, increased heterogeneity and mutational burden, and immunosuppression from the brain environment and tumor itself.

methodsWe have reviewed clinical and preclinical studies investigating how different doses (dose intense (DI) and metronomic) and timing of immunotherapy following TMZ treatment can eradicate tumor cells, alter tumor mutational burden, and change immune cells.

resultsRecent clinical trials with standard of care (SoC), DI and metronomic TMZ regimes are no able to completely eradicate GBM. Elevated TMZ levels in DI treatment can overcome MGMT resistance but may result in hypermutation of surviving tumor cells. Higher levels of TMZ will also generate a higher degree of lymphopenia compared to SoC and metronomic regimes in preclinical studies.

conclusionThe different levels of lymphopenia and tumor eradication discussed in this review suggest possible beneficial pairings between immunotherapy and TMZ treatment. Treatments resulting in profound lymphopenia will allow for expansion of vaccine specific T cells or of CAT T cells. Clinical and preclinical studies are currently comparing different combinations of TMZ and immunotherapy timing to treat GBM through a balance between tumor killing and immune cell expansion. More frequent immune monitoring time points in ongoing clinical trials are crucial for further development of these combinations.

Indexed as

Brain NeoplasmsAntineoplastic Agents, AlkylatingCell Line, TumorGlioblastomaHumansImmunotherapyLymphopeniaTemozolomideTreatment OutcomeAntineoplastic Agents, AlkylatingTemozolomideChemotherapyGlioblastomaImmunotherapyMGMTMMRTemozolomide

Identifiers

PMID32813186
PMCPMC9833842
OpenAlexW3079191246

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.