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A window-of-opportunity trial in recurrent GBM found that neoadjuvant (pre-surgery) dual immunotherapy with nivolumab (Opdivo) and ipilimumab (Yervoy) significantly increased the number of immune cells infiltrating the tumor compared with placebo. Median overall survival was 402 days among patients who received the dual immunotherapy (including patients who received the combo both before and after surgery and those who received it only after surgery), compared with 273 days for those who got nivolumab alone. Exploratory analyses also found increased activity in blood markers associated with immune system activation for patients receiving the dual treatment. Higher levels of tumor-infiltrating immune cells and early signs of immune activation were associated with improved survival, while tumor mutational burden was not. These results show that dual checkpoint blockade can activate immune responses in GBM, and we hope to see further studies to validate whether this strategy can help improve survival outcomes.