Preliminary evaluation of concurrent radiochemotherapy plus pucotenlimab in adult high-grade gliomas: a single-institution retrospective observational study

Abstract Objective High-grade gliomas (HGGs) are WHO grade Ⅲ - Ⅳ malignant brain tumors associated with a dismal prognosis. Despite the availability of multimodal treatment approaches, the 5-year survival rate remains < 5%, underscoring the urgent need for novel therapeutic strategies to improve outcomes in this aggressive disease. Methods This retrospective analysis included patients with histologically confirmed HGGs who received radiochemotherapy combined with pucotenlimab, a humanized anti-programmed death receptor 1 (PD-1) monoclonal antibody, at You’anmen Hospital (April 2023–October 2025). The primary endpoints were the objective response rate (ORR), and the secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results The therapeutic regimen combining pucotenlimab with concurrent chemotherapy and radiotherapy yielded an ORR of 36% (9/25), with disease control achieved in 92% (23/25) of the cases. Notably, responses were observed across different tumor locations, including challenging brainstem lesions (32% of cases). Median progression-free survival was 9.4 months, with a median overall survival of 15.2 months. The safety profile was favorable and indicated good tolerance to the treatment. Conclusions Pucotenlimab combined with radiochemotherapy demonstrates preliminary antitumor activity and warrants further prospective validation in HGGs.