Immunotherapy for Glioblastoma

Glioblastoma is a complex and fast-growing type of neurologic tumor that develops in glial cells, which support nerve cells in the brain and spinal cord. The cancer tends to be aggressive and can invade nearby critical structures, making it challenging to treat.

Typically, glioblastoma requires a comprehensive treatment approach. Many patients benefit from a combination of surgery, radiation therapy and chemotherapy, and additional therapies may be considered depending on the response and any recurrence.

While glioblastoma treatment is available and continually improving, the condition is often difficult to cure with today’s standard therapies. Even when the visible tumor is removed, microscopic cancer cells may remain in the surrounding brain tissues, which is one reason why recurrence is common. That said, researchers are continually working to improve outcomes, and newer approaches, including immunotherapies, are part of that progress.

Immunotherapy may be a promising option for certain patients, such as those with advanced or recurrent glioblastoma. However, it is not a one-size-fits-all treatment. To determine whether immunotherapy is appropriate, the healthcare team will evaluate multiple factors, including the location and molecular features of the tumor and the patient’s overall health, treatment history and candidacy for clinical trials.

How does immunotherapy work?

Immunotherapy is a cancer treatment that can help the immune system better recognize and attack glioblastoma cells. Instead of targeting the tumor directly—the way surgery and radiation therapy do—immunotherapy works by strengthening or guiding the body’s natural defenses.

Cancer cells can sometimes evade detection by the immune system or shut down the body’s immune response. Immunotherapy aims to change that by helping immune cells identify glioblastoma cells as abnormal and respond more effectively.

The types of immunotherapy for glioblastoma include:

• Checkpoint inhibitors – Specialized drugs can lift the “brakes” on the immune system so the immune cells can attack the cancer.
• Therapeutic vaccines and some investigational approaches – Novel medications aim to train the immune system to better recognize tumor-related targets.
• Biologic and immune-based therapies currently being explored in clinical trials – New options can support immune activity in ways that may help the body identify and destroy tumor cells.

If the patient is a candidate for immunotherapy, the physician will explain the recommended approach, why it may be appropriate and the results that can reasonably be expected.

When is immunotherapy used for glioblastoma?

Glioblastoma behaves differently from many other cancers, and its treatment is usually multimodal, which means several therapies may be combined or sequenced to help the patient achieve the best possible outcome and quality of life. Often, immunotherapy is considered in the context of a comprehensive treatment plan and, in many cases, through clinical trials that match the patient to new or emerging strategies.

Immunotherapy for glioblastoma may be used:

• Alongside standard treatments, such as surgery, radiation therapy and chemotherapy
• After surgery to help the immune system target any remaining cancer cells that could not be safely removed
• At recurrence, when the tumor returns or progresses after prior therapies, often with consideration for clinical trials

The healthcare team will explain how immunotherapy may fit into the overall treatment plan and whether combining it with other therapies may offer the most benefit.

"Moffitt was there for me and they were there to finish the race with me."

Lori, Glioblastoma Survivor

Request an Appointment

Why is immunotherapy used for glioblastoma?

Immunotherapy offers a different way to fight glioblastoma than traditional treatments, such as surgery, radiation therapy and chemotherapy. Instead of focusing solely on the tumor mass, immunotherapy aims to mobilize the immune system to recognize and attack cancer cells that may be difficult to reach with other treatments.

This approach can be especially beneficial for glioblastoma because the tumor can infiltrate healthy brain tissues, making complete removal challenging. For this reason, the treatment plan must address both the primary tumor and microscopic cancer cells. Additionally, if glioblastoma recurs, many patients seek further treatment at the time of recurrence, after standard therapies were already used.

Immunotherapy for glioblastoma is generally used with one or more of the following goals in mind:

• To control the cancer or slow the growth of the tumor – Immunotherapy may help the immune system keep the cancer in check and slow its progression.
• To shrink the tumor before surgery – Some investigational immunotherapies have shown a promising tumor response in select patients, but the results can vary.
• To target residual cancer cells after surgery – The aim of surgery is a maximal safe resection, but glioblastoma cells may remain after the procedure. Additional therapies, which may include immunotherapy in select cases, can be used to help address the remaining cancer cells.
• To relieve symptoms or improve quality of life when surgery is not an option – If the tumor cannot be safely removed, the treatment plan may focus on controlling the cancer, reducing the symptoms and supporting the patient’s daily function.

What to expect before, during and after immunotherapy for glioblastoma

Starting immunotherapy can feel uncertain, especially when the patient is already navigating a complex diagnosis of glioblastoma. Knowing what to expect can make the process feel more manageable.

How to prepare for immunotherapy for glioblastoma

Glioblastoma treatment is often developed and overseen by a multispecialty team, which may include neurosurgeons, medical neuro-oncologists, radiation oncologists and supportive care specialists who can help manage symptoms, side effects and quality of life. The patient may also work with advanced practice providers, oncology nurses, pharmacists, rehabilitation specialists, social workers and dietitians. This team-based approach can help ensure the patient receives coordinated care and ongoing support.

To help the patient prepare for immunotherapy, the healthcare team will review the treatment plan step by step, answer any questions and provide close monitoring throughout the process. The experience can vary depending on the type of immunotherapy administered and whether it is given alone or in conjunction with other treatments.

Typically, the patient will undergo a thorough medical evaluation to confirm that immunotherapy is appropriate and plan treatment. Common preparation steps include:

• An initial consultation and medical history review, including an in-depth discussion about any autoimmune conditions, prior therapies and medications
• Imaging studies, such as magnetic resonance imaging (MRI) scans, to map the tumor and evaluate the surrounding brain structures
• Laboratory testing to assess organ function and baseline blood cell counts
• Treatment planning to outline the goals, timing and integration of immunotherapy with surgery, radiation therapy and/or chemotherapy

If multiple therapies are included in the treatment plan, the healthcare team will review any additional preparation steps and explain the purpose of each. For example, radiation therapy planning may involve skin markers, custom immobilization devices and simulation sessions to support accurate tumor targeting. The patient will be encouraged to ask questions at every stage to help ensure they understand what to expect and how each step supports their care.

One of the World's Best Cancer Hospitals

Moffitt is recognized as a top cancer hospital, ranking high on Newsweek's list of World's Best Specialized Hospitals – Oncology 2025.

Schedule an Appointment

What happens during immunotherapy for glioblastoma?

The immunotherapy schedule can vary depending on the treatment plan, which will be individualized based on the patient’s diagnosis, overall health and type of medication prescribed. Some therapies are given in repeating cycles, such as every two, three or four weeks, while others may follow a different timeline, particularly in a clinical trial.

On each treatment day, the patient can generally expect:

• Arrival and check-in – After arriving at the treatment center, the patient will confirm their information and go over their medications.
• Pretreatment assessment – A nurse or clinician may check the patient’s vital signs and ask about any side effects or new concerns. Some visits may also include lab work.
• Treatment administration – Many immunotherapies are delivered through an intravenous (IV) infusion. The patient will be seated comfortably, and the infusion may take anywhere from 30 minutes to a few hours, depending on the specific medication.
• Monitoring during and after treatment – The healthcare team will closely watch for any infusion-related reactions or side effects. Most patients go home on the same day.

The goal is to make treatment as predictable and comfortable as possible. If the patient feels anxious at any time, they should promptly express their concerns. The healthcare team can explain exactly what is happening, help the patient prepare for each step and provide supportive care if needed.

What are the potential risks and complications of immunotherapy for glioblastoma?

All cancer treatments have risks. With immunotherapy, the side effects are often related to an activated immune response. Some reactions may be mild and localized, while others can involve broader immune-related inflammation that requires prompt medical attention. The healthcare team will describe what symptoms to watch for and when to call.

Common side effects of immunotherapy for glioblastoma include:

• Fatigue – The patient may feel more tired than usual, which can affect their work and daily routines. Rest, pacing and light activity may help.
• Flu-like symptoms – Fever, chills and body aches may occur as the immune system becomes activated. Typically, these symptoms can be managed with supportive medications and hydration strategies.
• Headaches – Any head pain should be reported promptly, especially with a brain tumor diagnosis, so the healthcare team can evaluate the cause.
• Nausea or decreased appetite – The patient may experience digestive upset, which can usually be alleviated with dietary adjustments and anti-nausea medications.
• Skin changes – Immune-related skin irritation, rash or itching may occur. The healthcare team may suggest topical treatments or medications if needed.
• Infusion-related reactions – During or shortly after IV treatment, the patient may experience flushing, shortness of breath or low blood pressure. If so, the healthcare team will respond quickly.

Many patients tolerate immunotherapy well, but side effects can occur. The earlier the symptoms are reported, the easier it will be for the healthcare team to address them. Most side effects of immunotherapy are temporary and manageable with medications, pauses in treatment or other supportive strategies.

What are the possible late-onset and long-term side effects of immunotherapy for glioblastoma?

Some immunotherapy-related side effects may appear weeks or months after treatment begins, or even after treatment ends. Ongoing follow-up is an important part of care, and the healthcare team will closely monitor the patient over time.

Possible late-onset and long-term effects of immunotherapy include:

• Thyroid, adrenal or pituitary issues – Certain immunotherapy drugs can affect hormone levels, leading to fatigue, weight changes, mood swings or temperature sensitivity. Some patients may require long-term hormone replacement therapy.
• Organ inflammation – Immune-related inflammation in the lungs, liver, intestines or other organs may cause symptoms such as shortness of breath, abdominal pain or persistent diarrhea. While these effects are usually treatable, they do require medical attention.
• Neurologic effects – Rarely, immune-related inflammation can affect the nervous system. Because glioblastoma itself can also affect neurologic function, it is especially important to report new or worsening symptoms right away.
• Ongoing tiredness or reduced stamina – Some patients experience long-lasting fatigue, particularly if immunotherapy is combined with other treatments.

Managing daily life during immunotherapy for glioblastoma

During immunotherapy for glioblastoma, day-to-day support matters. Many patients find that small adjustments to their daily routines can make treatment easier to tolerate and help them feel more in control. In general, the healthcare team may recommend:

• Getting proper nutrition – A balanced diet with adequate protein can support strength and recovery during treatment. Smaller, more frequent meals may help with reduced appetite. If the patient is experiencing weight loss or difficulty eating, they may find it helpful to consult a dietitian.
• Staying active within limits – Light movement, such as short walks and gentle stretches, can help improve energy, mood and sleep. The healthcare team can recommend safe activity levels, which is especially important if the patient is experiencing neurologic symptoms.
• Protecting the skin – Avoiding hot showers and using gentle, fragrance-free soaps and skincare products can help prevent rashes and irritation. The patient should report any skin changes promptly so they can be treated early.
• Practicing good hygiene – To help prevent infection, the patient should wash their hands thoroughly and often, avoid close contact with people who are ill and ask the healthcare team about any recommended vaccines and other specific precautions.
• Tracking medications and symptoms – The patient should keep an updated list of their medications and make notes about any side effects, including when they started and what makes them better or worse. This information can be discussed during medical appointments so the healthcare team can respond quickly.
• Scheduling follow-up care – Imaging and clinic visits will be essential to track the effectiveness of the treatment plan, make adjustments as needed and manage any late-onset side effects.

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s renowned Neuro-Oncology Program offers highly individualized glioblastoma treatment. Our patients also benefit from:

• A dedicated neuro-oncology tumor board that meets regularly to coordinate complex care plans and review options
• Access to novel therapies through our robust portfolio of clinical trials, including promising new immunotherapies and other emerging approaches
• A comprehensive approach focused on outcomes and quality of life, with supportive services available in the same convenient location

Research continues to enhance outcomes for many patients with glioblastoma. Improved survival has been observed in patients who undergo surgery removing at least 90% of the tumor, receive radiation therapy combined with temozolomide and access novel therapies such as immunotherapies through clinical trials.

If you would like to learn more about immunotherapy for glioblastoma, you can request an appointment with a specialist in our Neuro-Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.