Evidence map›Paper›PMID 37841696›Full record

ArticleNeuro-oncology advances

NUTMEG: A randomized phase II study of nivolumab and temozolomide versus temozolomide alone in newly diagnosed older patients with glioblastoma.

Hao-Wen Sim, Luke Wachsmuth, Elizabeth H Barnes, Sonia Yip, Eng-Siew Koh, Merryn Hall, Ross Jennens, David M Ashley, Roel G Verhaak, Amy B Heimberger and 19 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 7 pooled it
4.1field-weighted citation impact, top 5% 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

23 citing papers in PubMed, 7 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Cancer-related fatigue during treatment with neoadjuvant and/or adjuvant immune checkpoint inhibitors: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
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  6. Anti-PD-1 and anti-PD-L1 antibodies for glioma.The Cochrane database of systematic reviews · 2025
    Pooled it
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  13. Advances and challenges in glioblastoma immunotherapy: a meta-analysis of immune checkpoint inhibitors.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
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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

29 authors at 19 institutions in 2 countries.

Hao-Wen SimNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Luke WachsmuthThe Brain Tumor Immunotherapy Program, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Elizabeth H BarnesNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Sonia YipNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Eng-Siew KohFaculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-1664-2513
Merryn HallNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Ross JennensDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
David M AshleyThe Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Roel G VerhaakThe Jackson Laboratory for Genomic Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
Amy B HeimbergerDepartment of Neurological Surgery, Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
Mark A RosenthalDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Elizabeth J HoveyFaculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Benjamin M EllingsonUCLA Brain Tumor Imaging Laboratory, University of California Los Angeles, Los Angeles, California, USA.
Annette TognelaDepartment of Medical Oncology, Campbelltown Hospital, Sydney, New South Wales, Australia.
Hui K GanDepartment of Medical Oncology, Austin Hospital, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-7319-8546
Helen WheelerDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Michael BackDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Kerrie L McDonaldFaculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Anne LongDepartment of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Katharine CuffDepartment of Medical Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Stephen BegbieDepartment of Medical Oncology, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia.
Craig GedyeDepartment of Medical Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
Anna MislangCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Hien LeDepartment of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Margaret O JohnsonThe Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Benjamin Y KongNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
John R SimesNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
Zarnie LwinSchool of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Mustafa KhasrawNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-3249-9849
The University of Sydney · AUDuke University · USRoyal North Shore Hospital · AUUNSW Sydney · AUAustin Hospital · AUCalvary Mater Newcastle Hospital · AUCamden and Campbelltown Hospitals · AUEpworth Hospital · AUFlinders University · AUJackson Laboratory · USLiverpool Hospital · AUNorthwestern University · USPeter MacCallum Cancer Centre · AUPort Macquarie Base Hospital · AUPrincess Alexandra Hospital · AURoyal Adelaide Hospital · AUSir Charles Gairdner Hospital · AUThe University of Queensland · AUUniversity of California, Los Angeles · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007171 · NIGMS · DUKE UNIVERSITY · PI KONTOS, CHRISTOPHER D · 1985 to 2021
$31.2M
UCLA SPORE in Brain CancerP50CA211015 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Yvonne Yu-Hsuan Chen · 2017 to 2026
$25.2M
Role of decorin and diffusion MRI in anti-VEGF efficacy for recurrent glioblastomaR01CA270027 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI TIMOTHY CLOUGHESY, Benjamin M. Ellingson · 2022 to 2026
$3.0M
Quantitative molecular MR-PET imaging of glycolysis in glioblastomaR01CA279984 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Benjamin M. Ellingson, David A. Nathanson · 2023 to 2026
$2.4M
NCI NIH HHS P50 CA211015NCI NIH HHS R01 CA270027NCI NIH HHS R01 CA279984NIGMS NIH HHS T32 GM007171
6 · The paper itself

Abstract

Background: There is an immunologic rationale to evaluate immunotherapy in the older glioblastoma population, who have been underrepresented in prior trials. The NUTMEG study evaluated the combination of nivolumab and temozolomide in patients with glioblastoma aged 65 years and older. Methods: NUTMEG was a multicenter 2:1 randomized phase II trial for patients with newly diagnosed glioblastoma aged 65 years and older. The experimental arm consisted of hypofractionated chemoradiation with temozolomide, then adjuvant nivolumab and temozolomide. The standard arm consisted of hypofractionated chemoradiation with temozolomide, then adjuvant temozolomide. The primary objective was to improve overall survival (OS) in the experimental arm. Results: A total of 103 participants were randomized, with 69 in the experimental arm and 34 in the standard arm. The median (range) age was 73 (65-88) years. After 37 months of follow-up, the median OS was 11.6 months (95% CI, 9.7-13.4) in the experimental arm and 11.8 months (95% CI, 8.3-14.8) in the standard arm. For the experimental arm relative to the standard arm, the OS hazard ratio was 0.85 (95% CI, 0.54-1.33). In the experimental arm, there were three grade 3 immune-related adverse events which resolved, with no unexpected serious adverse events. Conclusions: Due to insufficient evidence of benefit with nivolumab, the decision was made not to transition to a phase III trial. No new safety signals were identified with nivolumab. This complements the existing series of immunotherapy trials. Research is needed to identify biomarkers and new strategies including combinations.

Indexed as

clinical trialsglioblastomaimmunotherapyolder cancer patientssystemic therapy

Identifiers

PMID37841696
PMCPMC10576515
OpenAlexW4386947419

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.