Desbaillets Nicolas, Hottinger Andreas Felix
Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois & Université de Lausanne, 1011 Lausanne, Switzerland.
Department of Oncology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Cancers (Basel). 2021 Jul 24;13(15):3721. doi: 10.3390/cancers13153721.
Glioblastoma is the most frequent and the most aggressive brain tumor. It is notoriously resistant to current treatments, and the prognosis remains dismal. Immunotherapies have revolutionized the treatment of numerous cancer types and generate great hope for glioblastoma, alas without success until now. In this review, the rationale underlying immune targeting of glioblastoma, as well as the challenges faced when targeting these highly immunosuppressive tumors, are discussed. Innovative immune-targeting strategies including cancer vaccines, oncolytic viruses, checkpoint blockade inhibitors, adoptive cell transfer, and CAR T cells that have been investigated in glioblastoma are reviewed. From a clinical perspective, key clinical trial findings and ongoing trials are discussed for each approach. Finally, limitations, either biological or arising from trial designs are analyzed, and strategies to overcome them are presented. Proof of efficacy for immunotherapy approaches remains to be demonstrated in glioblastoma, but our rapidly expanding understanding of its biology, its immune microenvironment, and the emergence of novel promising combinatorial approaches might allow researchers to finally fulfill the medical need for GBM patients.
胶质母细胞瘤是最常见且最具侵袭性的脑肿瘤。它对当前治疗具有众所周知的抗性,预后仍然不佳。免疫疗法已经彻底改变了多种癌症类型的治疗方式,并为胶质母细胞瘤带来了巨大希望,可惜至今尚未取得成功。在这篇综述中,讨论了针对胶质母细胞瘤进行免疫靶向治疗的基本原理,以及靶向这些高度免疫抑制性肿瘤时所面临的挑战。对包括癌症疫苗、溶瘤病毒、检查点阻断抑制剂、过继性细胞转移和嵌合抗原受体(CAR)T细胞等已在胶质母细胞瘤中进行研究的创新免疫靶向策略进行了综述。从临床角度出发,针对每种方法讨论了关键临床试验结果及正在进行的试验。最后,分析了生物学方面或试验设计方面的局限性,并提出了克服这些局限性的策略。免疫治疗方法的疗效证据在胶质母细胞瘤中仍有待证明,但我们对其生物学、免疫微环境的快速深入了解以及新出现的有前景的联合方法,可能会使研究人员最终满足胶质母细胞瘤患者的医疗需求。