Montoya Megan L, Kasahara Noriyuki, Okada Hideho
Department of Neurological Surgery, University of California San Francisco, San Francisco, California, US.
Department of Radiation Oncology, University of California San Francisco, San Francisco, California, US.
Neurooncol Pract. 2020 Mar 9;7(5):465-476. doi: 10.1093/nop/npaa007. eCollection 2020 Oct.
Malignant gliomas, including glioblastoma (GBM) as the most aggressive type of adult CNS tumors, are notoriously resistant to current standard of care treatments, including surgery, systemic chemotherapy, and radiation therapy (RT). This lack of effective treatment options highlights the urgent need for novel therapies, including immunotherapies. The overarching goal of immunotherapy is to stimulate and activate the patient's immune system in a targeted manner to kill tumor cells. The success of immunotherapeutic interventions in other cancer types has led to interest in and evaluation of various experimental immunotherapies in patients with malignant gliomas. However, these primary malignant brain tumors present a challenge because they exist in a vital and sensitive organ with a unique immune environment. The challenges and current status of experimental immunotherapeutic approaches, including vaccines, immune-checkpoint blockade, chimeric antigen receptor T-cell therapy, and oncolytic viruses will be discussed, as well as the potential for combinatorial therapies.
恶性胶质瘤,包括作为成人中枢神经系统肿瘤中最具侵袭性类型的胶质母细胞瘤,对包括手术、全身化疗和放射治疗(RT)在内的当前标准治疗方案具有众所周知的抗性。缺乏有效的治疗选择凸显了对包括免疫疗法在内的新型疗法的迫切需求。免疫疗法的总体目标是以靶向方式刺激和激活患者的免疫系统以杀死肿瘤细胞。免疫治疗干预在其他癌症类型中的成功引发了对恶性胶质瘤患者进行各种实验性免疫疗法的兴趣和评估。然而,这些原发性恶性脑肿瘤构成了一项挑战,因为它们存在于具有独特免疫环境的重要且敏感的器官中。将讨论实验性免疫治疗方法的挑战和现状,包括疫苗、免疫检查点阻断、嵌合抗原受体T细胞疗法和溶瘤病毒,以及联合疗法的潜力。