Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Expert Rev Anticancer Ther. 2022 Sep;22(9):957-980. doi: 10.1080/14737140.2022.2110072. Epub 2022 Aug 12.
The selection of a tailored and successful strategy for high-grade gliomas (HGGs) treatment is still a concern. The abundance of aberrant mutations within the heterogenic genetic landscape of glioblastoma strongly influences cell expansion, proliferation, and therapeutic resistance. Identification of immune evasion pathways opens the way to novel immune-based strategies. This review intends to explore the emerging immunotherapies for HGGs. The immunosuppressive mechanisms related to the tumor microenvironment and future perspectives to overcome glioma immunity barriers are also debated.
An extensive literature review was performed on the PubMed/Medline and ClinicalTrials.gov databases. Only highly relevant articles in English and published in the last 20 years were selected. Data about immunotherapies coming from preclinical and clinical trials were summarized.
The overall level of evidence about the efficacy and safety of immunotherapies for HGGs is noteworthy. Monoclonal antibodies have been approved as second-line treatment, while peptide vaccines, viral gene strategies, and adoptive technologies proved to boost a vivid antitumor immunization. Malignant brain tumor-treating fields are ever-changing in the upcoming years. Constant refinements and development of new routes of drug administration will permit to design of novel immune-based treatment algorithms thus improving the overall survival.
选择针对高级别神经胶质瘤（HGG）的个体化和成功的治疗策略仍然是一个关注点。胶质母细胞瘤异质性遗传景观中异常突变的大量存在强烈影响细胞的扩张、增殖和治疗耐药性。免疫逃逸途径的鉴定为新型免疫策略开辟了道路。本综述旨在探讨针对 HGG 的新兴免疫疗法。还讨论了与肿瘤微环境相关的免疫抑制机制以及克服神经胶质瘤免疫障碍的未来前景。
在 PubMed/Medline 和 ClinicalTrials.gov 数据库上进行了广泛的文献综述。仅选择了过去 20 年发表的高度相关的英文文章。总结了来自临床前和临床试验的免疫疗法数据。
免疫疗法对 HGG 的疗效和安全性的总体证据水平值得关注。单克隆抗体已被批准作为二线治疗，而肽疫苗、病毒基因策略和过继性技术已被证明可以增强抗肿瘤免疫。恶性脑肿瘤治疗电场在未来几年中不断变化。不断改进和开发新的药物给药途径将能够设计新的基于免疫的治疗算法，从而提高整体生存率。
