Department of Pharmacy, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
J Exp Clin Cancer Res. 2020 Nov 23;39(1):257. doi: 10.1186/s13046-020-01778-6.
Gliomas, especially glioblastomas, represent one of the most aggressive and difficult-to-treat human brain tumors. In the last few decades, clinical immunotherapy has been developed and has provided exceptional achievements in checkpoint inhibitors and vaccines for cancer treatment. Immunization with cellular vaccines has the advantage of containing specific antigens and acceptable safety to potentially improve cancer therapy. Based on T cells, dendritic cells (DC), tumor cells and natural killer cells, the safety and feasibility of cellular vaccines have been validated in clinical trials for glioma treatment. For TAA engineered T cells, therapy mainly uses chimeric antigen receptors (IL13Rα2, EGFRvIII and HER2) and DNA methylation-induced technology (CT antigen) to activate the immune response. Autologous dendritic cells/tumor antigen vaccine (ADCTA) pulsed with tumor lysate and peptides elicit antigen-specific and cytotoxic T cell responses in patients with malignant gliomas, while its pro-survival effect is biased. Vaccinations using autologous tumor cells modified with TAAs or fusion with fibroblast cells are characterized by both effective humoral and cell-mediated immunity. Even though few therapeutic effects have been observed, most of this therapy showed safety and feasibility, asking for larger cohort studies and better guidelines to optimize cellular vaccine efficiency in anti-glioma therapy.
神经胶质瘤,尤其是胶质母细胞瘤,是最具侵袭性和最难治疗的人类脑肿瘤之一。在过去的几十年中,临床免疫疗法已经发展起来,并在癌症治疗的检查点抑制剂和疫苗方面取得了非凡的成就。细胞疫苗的免疫接种具有包含特定抗原和可接受安全性的优势,有可能改善癌症治疗。基于 T 细胞、树突状细胞 (DC)、肿瘤细胞和自然杀伤细胞,细胞疫苗在用于治疗神经胶质瘤的临床试验中已验证了其安全性和可行性。对于 TAA 工程化 T 细胞,治疗主要使用嵌合抗原受体 (IL13Rα2、EGFRvIII 和 HER2) 和 DNA 甲基化诱导技术 (CT 抗原) 来激活免疫反应。用肿瘤裂解物和肽脉冲处理的自体树突状细胞/肿瘤抗原疫苗 (ADCTA) 在恶性神经胶质瘤患者中引发抗原特异性和细胞毒性 T 细胞反应,而其生存促进作用则存在偏向性。使用 TAA 修饰的自体肿瘤细胞或与成纤维细胞融合的疫苗接种具有有效的体液和细胞介导免疫的特点。尽管观察到的治疗效果很少,但这种治疗大多表现出安全性和可行性,需要更大的队列研究和更好的指南来优化细胞疫苗在抗神经胶质瘤治疗中的效率。