Unlocking the Glioblastoma Enigma: Exploring PD-L1, IDH 1 expression and their Immunotherapeutic Implications

Summary: INTRODUCTION : In the quest for effective Glioma therapies, we explore the intricate immune landscape. Immunotherapies, though promising, demand precise predictive markers due to variable success rates. This study employs immunohistochemistry to evaluate PD-L1 and IDH1/2 in 45 glioma patients, aiming to link PD-L1 expression with glioma grades and IDH 1 mutation status robustly. RATIONALE : This study explores combination treatments and immune markers in glioblastoma multiforme (GBM) patients, aiming to provide predictive insights for immunotherapies. Emphasizing Glioma-specific biomarker development, it builds on 2018 research (Mantica et al. 2018; Araujo Moura et al. 2023) that showed promising effects of nivolumab, alone or with bevacizumab, in GBM patients post-radiation and chemotherapy. This study holds significant potential for advancing novel treatment strategies in the fight against GBM. Methodology: In this 2-year retrospective study at PIMS Hospital, immunohistochemistry with the PDL-1 antibody (clone 28-8) and IDH 1 markers was applied. Tumor cell analysis measured viable tumor cell percentage (TPS), as per guidelines for reporting PDL1 ( Clone 28-8) in glioma.IDH Which offers insights into Glioma patients' immune microenvironment. Limitations: A key limitation is the lack of patient follow-up data, hindering longitudinal conclusions. Further research is needed to overcome this limitation and broaden insights. This study illuminates the complex immune landscape in GBM, paving the way for future research and therapeutic advancements in managing glioblastoma multiforme. Results : In a chi-square test on 45 glioma cases, 66% of grade 2 gliomas expressed PDL1, and 75% of grade IV glioblastoma multiforme cases did too. However, no significant correlation was found between glioma grade and PDL1 expression. Notably, 73% of all cases had PDL1 expression, suggesting a potential therapeutic target. Conclusion : This study explores immune markers as potential predictors for GBM immunotherapies. While no significant grade-PDL1 correlation emerged, PDL1's presence in 73% of cases highlights therapeutic potential. Despite limitations, it advances our understanding of GBM's complex immune landscape, guiding future research and therapies.