Neurosurg Focus. 2021 Feb;50(2):E4. doi: 10.3171/2020.11.FOCUS20859.
The treatment for glioblastoma (GBM) has not seen significant improvement in over a decade. Immunotherapies target the immune system against tumor cells and have seen success in various cancer types. However, the efficacy of immunotherapies in GBM thus far has been limited. Systemic immunotherapies also carry with them concerns surrounding systemic toxicities as well as penetration of the blood-brain barrier. These concerns may potentially limit their efficacy in GBM and preclude the use of combinatorial immunotherapy, which may be needed to overcome the severe multidimensional immune suppression seen in GBM patients. The use of viral vectors to deliver immunotherapies directly to tumor cells has the potential to improve immunotherapy delivery to the CNS, reduce systemic toxicities, and increase treatment efficacy. Indeed, preclinical studies investigating the delivery of immunomodulators to GBM using viral vectors have demonstrated significant promise. In this review, the authors discuss previous studies investigating the delivery of local immunotherapy using viral vectors. They also discuss the future of these treatments, including the reasoning behind immunomodulator and vector selection, patient safety, personalized therapies, and the need for combinatorial treatment.
胶质母细胞瘤(GBM)的治疗十年来未见明显改善。免疫疗法针对免疫系统对抗肿瘤细胞,在各种癌症类型中已取得成功。然而,免疫疗法在 GBM 中的疗效迄今为止受到限制。全身免疫疗法也存在与全身毒性以及血脑屏障穿透有关的问题。这些问题可能会限制其在 GBM 中的疗效,并排除联合免疫疗法的使用,而联合免疫疗法可能是克服 GBM 患者严重的多维免疫抑制所必需的。使用病毒载体将免疫疗法直接递送至肿瘤细胞,有可能改善 CNS 中的免疫疗法递送,降低全身毒性并提高治疗效果。实际上,使用病毒载体研究将免疫调节剂递送至 GBM 的临床前研究已显示出巨大的潜力。在这篇综述中,作者讨论了之前使用病毒载体进行局部免疫疗法递送的研究。他们还讨论了这些治疗方法的未来,包括免疫调节剂和载体选择、患者安全性、个性化治疗以及联合治疗的必要性背后的原因。