Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Tsu, Japan.
Adv Exp Med Biol. 2012;746:202-15. doi: 10.1007/978-1-4614-3146-6_16.
Immunological effector cells and molecules have been shown to access intracranial tumor sites despite the existence of blood brain barrier (BBB) or immunosuppressive mechanisms associated with brain tumors. Recent progress in T-cell biology and tumor immunology made possible to develop strategies of tumor-associated antigen-specific immunotherapeutic approaches such as vaccination with defined antigens and adoptive T-cell therapy with antigen-specific T cells including gene-modified T cells for the treatment of patients with brain tumors. An array of recent reports on the trials of active and passive immunotherapy for patients with brain tumors have documented safety and some preliminary clinical efficacy, although the ultimate judgment for clinical benefits awaits rigorous evaluation in trials of later phases. Nevertheless, treatment with lymphocytes that are engineered to express tumor-specific receptor genes is a promising immunotherapy against glioma, based on the significant efficacy reported in the trials for patients with other types of malignancy. Overcoming the relative difficulty to apply immunotherapeutic approach to intracranial region, current advances in the understanding of human tumor immunology and the gene-therapy methodology will address the development of effective immunotherapy of brain tumors.
免疫效应细胞和分子已被证明可以进入颅内肿瘤部位，尽管存在血脑屏障 (BBB) 或与脑肿瘤相关的免疫抑制机制。T 细胞生物学和肿瘤免疫学的最新进展使得开发肿瘤相关抗原特异性免疫治疗策略成为可能，例如用定义的抗原进行疫苗接种，以及用抗原特异性 T 细胞进行过继性 T 细胞治疗，包括基因修饰的 T 细胞，用于治疗脑肿瘤患者。最近有大量关于脑肿瘤患者主动和被动免疫治疗试验的报告，记录了安全性和一些初步的临床疗效，尽管最终的临床获益判断仍有待更严格的后期试验评估。然而，基于对其他类型恶性肿瘤患者试验中报告的显著疗效，用表达肿瘤特异性受体基因的淋巴细胞进行治疗是一种有前途的治疗胶质母细胞瘤的免疫疗法。为了克服将免疫治疗方法应用于颅内区域的相对困难，目前对人类肿瘤免疫学和基因治疗方法的理解的进展将解决脑肿瘤有效免疫治疗的发展问题。
