NorthWest Biotherapeutics Inc (NWBO)

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Mike,

Enlighten me why the unpublished paper seems like having conclusion different from the one published on Nature five years ago.

The published paper states that neoadjuvant therapy can double OS in comparison of adjuvant treatment while the unpublished paper claims that there is no survival benefit in neoadjuvant therapy.

https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE264695

Expression profiling by high throughput sequencing
SummaryGlioblastoma is immunologically “cold” and resistant to single-agent immune-checkpoint inhibitors (ICI). Our previous study of neoadjuvant pembrolizumab in surgically-accessible recurrent glioblastoma identified a molecular signature of response to ICI and suggested that neoadjuvant pembrolizumab may improve survival. To increase the power of this observation, we performed bulk-RNA seq on resected tumor tissue in an additional 25 patients with surgically-accessible recurrent glioblastoma. Neoadjuvant pembrolizumab was associated with suppression of cell cycle/cancer proliferation genes and upregulation of T-cell/interferon-related gene expression. This signature was unique to patients treated with neoadjuvant pembrolizumab and was an independent risk factor for survival. Our results demonstrate a clear pharmacodynamic effect of anti-PD1 therapy in glioblastoma and identify pathways that may mediate resistance. However, we did not confirm a survival benefit to neoadjuvant pembrolizumab in recurrent glioblastoma. Our new data suggests some patients may exhibit innate resistance to pre-surgical ICI and require other concomitant therapies to sensitize effectively.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6408961/

Patients who were randomized to receive neoadjuvant pembrolizumab, with continued adjuvant therapy following surgery, had significantly extended overall survival compared to patients that were randomized to receive adjuvant, post-surgical PD-1 blockade alone.