Association between autologous formalin-fixed tumor vaccine (AFTV) therapy, molecular pathological markers, and survival outcomes in glioblastoma.

Glioblastoma (GBM) is a primary brain tumor, characterized by rapid progression, high recurrence rates, and resistance to standard therapies. Current treatment modalities provide limited survival benefits, highlighting the need for novel therapeutic strategies. This retrospective study evaluated the efficacy of autologous formalin-fixed tumor vaccine (AFTV) in 375 patients with newly diagnosed GBM. Patients receiving AFTV therapy (n = 164) showed significantly improved progression-free survival (PFS; 14.0 months vs. 8.7 months, p = 0.03) and overall survival (OS; 32.0 months vs. 21.9 months, p < 0.01) compared with the non-AFTV group (n = 211). Subgroup analyses revealed that AFTV therapy was particularly effective in patients with wild-type IDH tumors and those negative for PD-L1 and p53 expression. In contrast, patients whose tumors were positive for both PD-L1 and p53 exhibited significantly poorer outcomes. These findings suggest that the combination of PD-L1 and p53 status may serve as a useful biomarker for predicting AFTV responsiveness, reflecting the influence of the immunosuppressive tumor microenvironment on treatment efficacy. These findings establish AFTV as a promising treatment option for GBM and highlight the importance of molecular profiling in treatment selection. Future studies should explore combining AFTV with immune checkpoint inhibitors to enhance efficacy in PD-L1-positive cases.