Society of Neuro-Oncology 2021 Annual Meeting Summary
Author: Yoshie Umemura, MD
Department of Neurology, Division of Neuro-Oncology, University of Michigan, Rogel Cancer Center, Ann Arbor, MI
SNO 2021 Meeting Summary
The 26th annual scientific meeting of the Society for Neuro-Oncology (SNO) was successfully held on November 18-21, 2021 in Boston, MA, as a hybrid in-person/virtual meeting. Over 1500 attended in person, and an additional 642 participated virtually, for a total of 2153 participants from 36 countries. Dr. Gelareh Zadeh concluded her term and passed the baton to incoming present, Dr. Tracy Batchelor. The Victor Levin Award Recipient, Dr. Timothy F. Cloughesy, spoke about life-long learning in his impactful career in Neuro-Oncology Research. The meeting also presented the Lifetime Achievement Award to Dr. Eric Bouffet and the Jan Esenwein Award for Public Service in Neuro-Oncology to Dr. Nicole Willmarth. After two years of virtual meetings and webinars through the global pandemic, this year’s meeting was buzzing with excitement. The return to in-person activities provided the irreplicable platform for the society members to re-connect with colleagues from around the world and exchange ideas. The meeting featured important presentations and updates including:
Keynote addresses on genomics, immunotherapies, treatment resistance in glioma, and updated WHO molecular classification of CNS tumors: This year’s keynote presentations began with the latest on genome editing by Dr. David Liu, and the current and future landscape of genomics & cancer by Dr. Gad Getz. Dr. David Louis presented updates on the 2021 WHO Classification of CNS Tumors. On the immunotherapy front, Dr. Akiko Iwasaki spoke on the potential for VEGF-C to prime lymph nodes in immune checkpoint therapy for brain tumors, and Dr. Christine E. Brown discussed promises and challenges of CAR-T cell therapy in glioblastoma. Dr. Maria Castro spoke of an exciting potential for G-CSF to improve glioma treatment during her presentation on reprogramming the tumor immune microenvironment, and she voiced the importance for research collaborations – a sentiment echoed by many presenters. Dr. Roel Varhaak discussed the role of ecDNA in deciphering glioma evolution and treatment resistance.
Modulation of immunosuppressive myeloid-derived suppressor cells may improve glioma therapy: Myeloid-derived suppressor cells (MDSCs) are associated with poor prognosis and treatment resistance of GBM patients and may drive disease progression. Bayik et al. presented the investigation of the differential function of monocytic MDSCs (mMDSCs) versus granulocytic MDSCs (gMDSCs) in glioblastoma to study the distinct role of individual populations of MDSCs.1 This abstract was awarded the WiN Abstract Award for Basic Science/Translational Research. In this study, mMDSCs were noted to be pro-tumorigenic due to upregulation of cell adhesion pathways. The blockade of integrin β1 and β7 led to dampened pro-tumorigenicity of mMDSCs and improved survival in tumor-bearing mice. The high expression of integrin β1 and β7 was also associated with poorer prognosis in GBM patients, indicating modulation of immunosuppressive myeloid cells may be a potential immunotherapeutic option for GBM. On a related note, Dr. Maria Castro discussed in her keynote presentation how granulocyte colony-stimulating factor (G-CSF) can trigger re-programing of bone marrow granulopoiesis to result in modulation of immunosuppressive MDSCs and enhanced efficacy of immune-stimulatory gene therapy.2
ONC201 monotherapy exhibits durable and clinically meaningful efficacy in recurrent H3 K27M-mutant diffuse midline glioma (DMG): At a plenary presentation, Arrillaga-Romany et al. presented the data on patients with H3 K27M-mutant DMG who were treated with oral ONC201 monotherapy on clinical trials and expanded access program.3 Fifty pediatric and adult patients with recurrent H3 K27M DMG were treated with ONC201, a first-in-class anti-cancer DRD2 antagonist and ClpP agonist, with ORR of 20% (95% CI: 10.0–33.7%) by RANO-HGG criteria and low study related adverse event rate at a median duration of response of 11.2 months (95% CI: 3.8 – not reached) and median time to response of 8.3 months (range 1.9–15.9). With a median follow-up of 18.8 months, median OS was 13.7 months (95% CI: 8.0–20.3) and OS at 24 months was 34.7% (95% CI: 20.7–49.2%).
Advances in artificial intelligence (AI) and novel imaging in the diagnosis and management of gliomas: As part of the main educational objectives of this year’s annual meeting, there were many intriguing presentations on AI and novel imaging diagnostics such as an award-winning abstract by Tran et al. on novel gene therapy approach targeting glioblastoma using AI-directed identification of the GBM state to circumvent the treatment challenges posed by tumor heterogeneity.5 Kazerooni et al., also with an award winning abstract, presented distinct radiogenomics signatures in key driver genes of several glioblastoma mutations that may contribute to pre-operative stratification of patients for molecular targeted therapies, and potentially longitudinal monitoring of mutational changes during treatment.6
Updates on Treatment of Primary CNS lymphoma: A 1.5-hour session on primary CNS lymphoma treatment led by experts in the field provided review of current treatment options for induction, consolidation options, and areas of debate that may merit future studies to reach a consensus. Novel therapies using targeted treatment and immunotherapy, as well as strategies to address minimal residual disease, were also discussed.
Financial toxicity in primary brain tumor patients during the COVID-19 pandemic: Leeper et al., assessed financial toxicity and associated patient reported outcomes after one year of lockdown in a cohort of patients with primary brain tumor and provided the first report of FACIT-COST in a cohort of 112 patients, receiving the Abstract Award for Excellence in Survivorship.6 This study demonstrated that non-White individuals with high grade glioma who are not currently working due to their tumor reported worse financial toxicity, a factor strongly correlated with higher symptom burden and interference. Future studies to assess financial toxicity longitudinally and post-pandemic are needed.
Women and Diversity Session: Dr. Joseph Betancourt discussed the importance of structural equity in race, gender, and ethnicity, and highlighted invaluable lessons learned from 2020. Women in Neuro-Oncology (WiN) Mid-Career Exemplary Physician Award was presented to Dr. Priscilla Brastianos. The WiN Mentorship Award was given to Dr. Amy Heimberger.
Over 100 recorded talks and presentations from this year’s annual meeting are currently available online for all registered attendees for up to a year. We look forward to seeing you at next year’s Society for Neuro-Oncology annual meeting November 16-20, 2022 in Tampa Bay, FL.
- Bayik D, Bartels C, Lovrenert K, et al. IMMU-21. DIFFERENTIAL EXPRESSION OF ADHESION MOLECULES DEFINES MYELOID CELL INFILTRATION IN GLIOBLASTOMA AND COMPRISES A THERAPEUTIC TARGET. Neuro Oncol. 2021;23(suppl_6):vi96, doi.org/10.1093/neuonc/noab196.380
- Alghamri MS, McClellan BL, Avvari RP, et al. C-CSF SECRETED BY MUTANT IDH1 GLIOMA STEM CELLS ABOLISHES MYELOID CELL IMMUNOSUPPRESSION AND ENHANCES THE EFFICACY OF IMMUNOTHERAPY. Sci Adv. 2021;7(40):eabh3243. doi:10.1126/sciadv.abh3243
- Arrillaga-Romany I, Kurz S, Tarapore R, et al. LTBK-05. CLINICAL EFFICACY OF ONC201 IN RECURRENT H3 K27M-MUTANT DIFFUSE MIDLINE GLIOMA PATIENTS. Neuro Oncol. 2021;23(suppl_6):vi230, doi.org/10.1093/neuonc/noab196.925
- Tran D, Le S, Ma B, et al. EXTH-51. DEVELOPMENT OF A NOVEL GENE THERAPY APPROACH TARGETING GLIOBLASTOMA FOLLOWING ARTIFICIAL INTELLIGENCE (AI)-DIRECTED IDENTIFICATION OF THE GBM STATE. Neuro Oncol. 2021;23(suppl_6):vi174–vi175, doi.org/10.1093/neuonc/noab196.690
- Kazerooni AF, Akbari H, Bakas S, et al. NIMG-52. RADIOGENOMICS SIGNATURES IN KEY DRIVER GENES IN GLIOBLASTOMA EVALUATED WITH AND WITHOUT THE PRESENCE OF CO-OCCURRING MUTATIONS. 2021;23(suppl_6): vi141, doi.org/10.1093/neuonc/noab196.550
- Leeper H, Vera E, Acquaye A, et al. QOLP-19. FINANCIAL TOXICITY AND DISTRESS DURING THE COVID-19 PANDEMIC IN PEOPLE LIVING WITH PRIMARY BRAIN TUMORS. Neuro Oncol. 2021;23(suppl_6):vi187, https://doi.org/10.1093/neuonc/noab196.740