Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Curr Treat Options Oncol. 2021 Jul 30;22(9):83. doi: 10.1007/s11864-021-00874-9.
Medulloblastoma (MB) is the most common pediatric brain malignancy, with a 5-year overall survival (OS) rate of around 65%. The conventional MB treatment, comprising surgical resection followed by irradiation and adjuvant chemotherapy, often leads to impairment in normal body functions and poor quality of life, especially with the increased risk of recurrence and subsequent development of secondary malignancies. The development and progression of MB are facilitated by a variety of immune-evading mechanisms such as the secretion of immunosuppressive molecules, activation of immunosuppressive cells, inhibition of immune checkpoint molecules, impairment of adhesive molecules, downregulation of the major histocompatibility complex (MHC) molecules, protection against apoptosis, and activation of immunosuppressive pathways. Understanding the tumor-immune relationship in MB is crucial for effective development of immune-based therapeutic strategies. In this comprehensive review, we discuss the immunological aspect of the brain, focusing on the current knowledge tackling the mechanisms of MB immune suppression and evasion. We also highlight several key immunotherapeutic approaches developed to date for the treatment of MB.
髓母细胞瘤（MB）是最常见的儿童脑恶性肿瘤，5 年总生存率（OS）约为 65%。MB 的传统治疗方法包括手术切除，随后进行放疗和辅助化疗，这通常会导致正常身体功能受损和生活质量下降，尤其是复发风险增加和随后继发恶性肿瘤的风险增加。MB 的发生和发展受到多种免疫逃避机制的促进，例如免疫抑制分子的分泌、免疫抑制细胞的激活、免疫检查点分子的抑制、黏附分子的损伤、主要组织相容性复合体（MHC）分子的下调、对细胞凋亡的保护以及免疫抑制途径的激活。了解 MB 中的肿瘤-免疫关系对于有效开发基于免疫的治疗策略至关重要。在这篇全面的综述中，我们讨论了脑的免疫学方面，重点介绍了目前针对 MB 免疫抑制和逃避机制的研究进展。我们还强调了迄今为止为治疗 MB 而开发的几种关键免疫治疗方法。
