Faculty of Medicine, Sumy State University, Sumy, Ukraine.
School of Medicine, Queen's University Belfast, Belfast, UK.
CNS Neurosci Ther. 2024 Sep;30(9):e70013. doi: 10.1111/cns.70013.
Gliomas, particularly glioblastoma multiforme (GBM), are highly aggressive brain tumors that present significant challenges in oncology due to their rapid progression and resistance to conventional therapies. Despite advancements in treatment, the prognosis for patients with GBM remains poor, necessitating the exploration of novel therapeutic approaches. One such emerging strategy is the development of glioma vaccines, which aim to stimulate the immune system to target and destroy tumor cells.
This review aims to provide a comprehensive evaluation of the current landscape of glioma vaccine development, analyzing the types of vaccines under investigation, the outcomes of clinical trials, and the challenges and opportunities associated with their implementation. The goal is to highlight the potential of glioma vaccines in advancing more effective and personalized treatments for glioma patients.
This narrative review systematically assessed the role of glioma vaccines by including full-text articles published between 2000 and 2024 in English. Databases such as PubMed/MEDLINE, EMBASE, the Cochrane Library, and Scopus were searched using key terms like "glioma," "brain tumor," "glioblastoma," "vaccine," and "immunotherapy." The review incorporated both pre-clinical and clinical studies, including descriptive studies, animal-model studies, cohort studies, and observational studies. Exclusion criteria were applied to omit abstracts, case reports, posters, and non-peer-reviewed studies, ensuring the inclusion of high-quality evidence.
Clinical trials investigating various glioma vaccines, including peptide-based, DNA/RNA-based, whole-cell, and dendritic-cell vaccines, have shown promising results. These vaccines demonstrated potential in extending survival rates and managing adverse events in glioma patients. However, significant challenges remain, such as therapeutic resistance due to tumor heterogeneity and immune evasion mechanisms. Moreover, the lack of standardized guidelines for evaluating vaccine responses and issues related to ethical considerations, regulatory hurdles, and vaccine acceptance among patients further complicate the implementation of glioma vaccines.
Addressing the challenges associated with glioma vaccines involves exploring combination therapies, targeted approaches, and personalized medicine. Combining vaccines with traditional therapies like radiotherapy or chemotherapy may enhance efficacy by boosting the immune system's ability to fight tumor cells. Personalized vaccines tailored to individual patient profiles present an opportunity for improved outcomes. Furthermore, global collaboration and equitable distribution are critical for ensuring access to glioma vaccines, especially in low- and middle-income countries with limited healthcare resources CONCLUSION: Glioma vaccines represent a promising avenue in the fight against gliomas, offering hope for improving patient outcomes in a disease that is notoriously difficult to treat. Despite the challenges, continued research and the development of innovative strategies, including combination therapies and personalized approaches, are essential for overcoming current barriers and transforming the treatment landscape for glioma patients.
神经胶质瘤，尤其是多形性胶质母细胞瘤（GBM），是高度侵袭性的脑肿瘤，由于其快速进展和对传统疗法的耐药性，给肿瘤学带来了重大挑战。尽管在治疗方面取得了进展，但 GBM 患者的预后仍然较差，需要探索新的治疗方法。一种新兴策略是开发神经胶质瘤疫苗，旨在刺激免疫系统靶向和破坏肿瘤细胞。
本综述旨在全面评估神经胶质瘤疫苗开发的现状，分析正在研究的疫苗类型、临床试验结果以及实施过程中面临的挑战和机遇。目的是强调神经胶质瘤疫苗在为神经胶质瘤患者提供更有效和个性化的治疗方面的潜力。
本叙述性综述系统评估了神经胶质瘤疫苗的作用，纳入了 2000 年至 2024 年期间以英文发表的全文文章。使用关键词如“神经胶质瘤”、“脑肿瘤”、“胶质母细胞瘤”、“疫苗”和“免疫疗法”，在 PubMed/MEDLINE、EMBASE、Cochrane 图书馆和 Scopus 等数据库中进行搜索。综述包括了临床前和临床研究，包括描述性研究、动物模型研究、队列研究和观察性研究。应用排除标准排除了摘要、病例报告、海报和非同行评议的研究，以确保纳入高质量的证据。
临床试验研究了各种神经胶质瘤疫苗，包括基于肽、DNA/RNA、全细胞和树突细胞的疫苗，结果显示出有希望的结果。这些疫苗在延长胶质母细胞瘤患者的生存率和控制不良反应方面显示出了潜力。然而，仍存在重大挑战，如由于肿瘤异质性和免疫逃逸机制导致的治疗耐药性。此外，缺乏评估疫苗反应的标准化指南以及与伦理考虑、监管障碍和患者对疫苗的接受度相关的问题进一步复杂化了神经胶质瘤疫苗的实施。
解决神经胶质瘤疫苗相关的挑战涉及探索联合疗法、靶向方法和个性化医疗。将疫苗与放疗或化疗等传统疗法联合使用可以通过增强免疫系统攻击肿瘤细胞的能力来提高疗效。针对个体患者特征量身定制的个性化疫苗为改善结果提供了机会。此外，全球合作和公平分配对于确保获得神经胶质瘤疫苗至关重要，特别是在医疗资源有限的低收入和中等收入国家。
神经胶质瘤疫苗是对抗神经胶质瘤的一个有前途的途径，为改善这种难以治疗的疾病患者的预后带来了希望。尽管存在挑战，但继续研究和开发创新策略，包括联合疗法和个性化方法，对于克服当前的障碍和改变神经胶质瘤患者的治疗格局至关重要。
