De Carli Emilie, Delion Matthieu, Rousseau Audrey
Unité hémato-onco-immunologie pédiatrique, fédération de pédiatrie, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
Département de neurochirurgie, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
Ann Pathol. 2017 Feb;37(1):117-126. doi: 10.1016/j.annpat.2016.12.001. Epub 2017 Jan 19.
Diffuse gliomas represent the most common primary central nervous system (CNS) tumors in adults and children alike. Glioblastoma is the most frequent and malignant form of diffuse glioma with a median overall survival of 15 months despite aggressive treatments. New therapeutic approaches are needed to prolong survival in this always fatal disease. The CNS has been considered for a long time as an immune privileged organ, in part because of the existence of the blood-brain barrier. Nonetheless, immunotherapy is a novel approach in the therapeutic management of glioma patients, which has shown promising results in several clinical trials, especially in the adult population. Vaccination, with or without dendritic cells, blockade of the immune checkpoints, and adoptive T cell transfer are the most studied modalities of diffuse glioma immunotherapy. The future most likely resides in combinatorial approaches, with administration of conventional treatments (surgery, radiochemotherapy) and immunotherapy following yet to determine schedules.
弥漫性胶质瘤是成人和儿童中最常见的原发性中枢神经系统(CNS)肿瘤。胶质母细胞瘤是弥漫性胶质瘤最常见且恶性程度最高的形式,尽管进行了积极治疗,其总体中位生存期仍为15个月。需要新的治疗方法来延长这种致命疾病患者的生存期。长期以来,中枢神经系统一直被视为免疫特惠器官,部分原因是血脑屏障的存在。尽管如此,免疫疗法是胶质瘤患者治疗管理中的一种新方法,在多项临床试验中已显示出有希望的结果,尤其是在成人患者中。接种疫苗(有或没有树突状细胞)、阻断免疫检查点和过继性T细胞转移是弥漫性胶质瘤免疫疗法研究最多的方式。未来最有可能采用联合治疗方法,按照尚未确定方案先后给予传统治疗(手术、放化疗)和免疫治疗。