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This combination therapy consists of Laser Interstitial Thermotherapy (LITT) and the immune checkpoint inhibitor pembrolizumab. LITT is a minimally invasive surgical procedure that uses laser energy to induce thermal ablation of tumor tissue, which is hypothesized to disrupt the blood-brain barrier and release tumor-associated antigens into the local environment. Pembrolizumab is a humanized monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor on T-cells, preventing its interaction with ligands PD-L1 and PD-L2. By combining these modalities, the treatment aims to leverage the cytoreductive and immune-priming effects of LITT to enhance the efficacy of pembrolizumab-mediated T-cell activation against recurrent brain metastases. This specific regimen is being evaluated by the University of Florida in the TORCH pilot study for patients with recurrent brain metastases who have failed prior stereotactic radiosurgery.
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