Han Seunggu J, Kaur Gurvinder, Yang Isaac, Lim Michael
Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Avenue, San Francisco, CA 94117, USA.
Neurosurg Clin N Am. 2010 Jan;21(1):1-16. doi: 10.1016/j.nec.2009.08.001.
The most common primary brain neoplasm is glioblastoma multiforme, which is associated with a dismal prognosis. Despite the recommended treatment regimen of aggressive surgical resection, radiation, and chemotherapy, the median survival remains approximately only 14 months. Due to these minimal improvements in survival of patients despite recent advances in conventional treatments, new modalities such as immunotherapy are being investigated and studied. A hurdle to developing effective immunotherapy is the immunosuppressive characteristics that are the hallmark of malignant gliomas. Effective therapeutic strategies will require overcoming these mechanisms, by augmenting tumor antigen presentation, perhaps in a setting isolated from the tumor microenvironment. The heterogeneity of potential glioma antigens warrants potential targeting of multiple tumor-specific antigens, and discovery and investigation of additional antigens. This article describes the current strategies and principles of immunotherapy for malignant gliomas.
最常见的原发性脑肿瘤是多形性胶质母细胞瘤,其预后很差。尽管推荐了积极的手术切除、放疗和化疗的治疗方案,但中位生存期仍仅约为14个月。由于尽管传统治疗方法最近有所进展,但患者的生存期改善甚微,因此正在研究和探讨免疫疗法等新的治疗方式。开发有效的免疫疗法的一个障碍是恶性胶质瘤所特有的免疫抑制特性。有效的治疗策略将需要通过增强肿瘤抗原呈递来克服这些机制,或许是在与肿瘤微环境隔离的环境中进行。潜在的胶质瘤抗原的异质性保证了对多种肿瘤特异性抗原的潜在靶向作用,以及对其他抗原的发现和研究。本文描述了恶性胶质瘤免疫疗法的当前策略和原则。
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