Grady Clare, Melnick Kaitlyn, Porche Ken, Dastmalchi Farhad, Hoh Daniel J, Rahman Maryam, Ghiaseddin Ashley
Department of Neurosurgery, University of Florida, Gainesville, FL, USA.
Neurospine. 2022 Mar;19(1):13-29. doi: 10.14245/ns.2143210.605. Epub 2022 Feb 2.
Spinal cord gliomas are rare entities that often have limited surgical options. Immunotherapy has shown promise in intracranial gliomas with some research suggesting benefit for spinal cord gliomas. A focused review of immunotherapies that have been investigated in spinal cord gliomas was performed. The primary methods of immunotherapy investigated in spinal cord gliomas include immune checkpoint inhibitors, adoptive T-cell therapies, and vaccine strategies. There are innumerable challenges that must be overcome to effectively apply immunotherapeutic strategies to the spinal cord gliomas including low incidence, few antigenic targets, the blood spinal cord barrier, the immunosuppressive tumor microenvironment and neurotoxic treatment effects. Nonetheless, research has suggested ways to overcome these challenges and treatments have been effective in case reports for metastatic non-small cell lung cancer, melanoma, midline glioma and glioblastoma. Current therapies for spinal cord gliomas are markedly limited. Further research is needed to determine if the success of immunotherapy for intracranial gliomas can be effectively applied to these unique tumors.
脊髓胶质瘤是罕见的疾病，手术选择往往有限。免疫疗法在颅内胶质瘤中已显示出前景，一些研究表明对脊髓胶质瘤也有益处。我们对已在脊髓胶质瘤中进行研究的免疫疗法进行了重点综述。在脊髓胶质瘤中研究的主要免疫疗法包括免疫检查点抑制剂、过继性T细胞疗法和疫苗策略。要将免疫治疗策略有效应用于脊髓胶质瘤，必须克服无数挑战，包括发病率低、抗原靶点少、血脊髓屏障、免疫抑制性肿瘤微环境和神经毒性治疗效应。尽管如此，研究已提出克服这些挑战的方法，并且在转移性非小细胞肺癌、黑色素瘤、中线胶质瘤和胶质母细胞瘤的病例报告中，治疗已取得成效。目前针对脊髓胶质瘤的治疗方法明显有限。需要进一步研究以确定颅内胶质瘤免疫疗法的成功经验能否有效应用于这些独特的肿瘤。
