[crispycas12]

It's neo-adjuvant (treat prior to surgery) with a three mAbs: Ipi + Nivo, which is a well established combo of immunotherapeutics for many solid tumors, rounded out with relatlimab which I'm less familiar with (LAG-3 inhibition). Neoadjuvant use of immunotherapies is established concept and is utilized in clinical practice for non-small cell lung cancer and colon cancer. This is the first time I've seen a use of 3 immunotherapies used at once: Ipi + Nivo isn't the most tolerable treatment regimen. Other novel aspect is use of neoadjuvant therapy in GBM.

[jsperx]

Don’t mean to hijack this thread, but I don’t think HN has DMs. Read some of your comments and as a person with cancer would love to pick your brain a little to develop my mental model further (and of course wouldn’t expect anything for free.) Drop me a line at [my HN username] [at] nearby.org if open to discussing more. Thanks!

[trhway]

Do they give immunotherapy before, after or instead of chemo? Asking because I heard what it is after in some cases and that puzzled me as chemo usually hits immune system.

[mcbain]

No chemo. The entire idea of this regime is to hit the tumour with immuno to get the reaction. They want lots of tumour cells and for it to be "treatment naive" - Richard hadn't even had corticosteroids, which dampens immune.

Once they primed his system they excised as much as possible and kept the immuno going while doing a course of radiation.

Profs Long and Scolyer work with melanoma where chemo is rarely used these days.

[mft_]

That was a concern in the early days of development of anti PD(L)-1 agents - that chemo and even steroids would harm the T-cells you’re trying to activate.

Yet there are settings where a deliberate combination of anti PD-1 with chemotherapy is the standard of care. And there are other types of immunotherapy where a combination with chemotherapy is advantageous too.

[femto]

From what I read (in a book written by Scolyer), the treatment didn't involve chemo. It was along the lines of: 1. immunotherapy 2. Surgery to remove the bulk of the tumour. 3. More immunotherapy 4. Radiation therapy 5. A course of vaccine customised to the genome of the cancer