Department of Neurology, Rush University Medical Center, Chicago, Illinois.
Department of Neurology and Neurosurgery, University of California, San Francisco, California, USA.
Curr Opin Neurol. 2024 Dec 1;37(6):666-671. doi: 10.1097/WCO.0000000000001320. Epub 2024 Sep 11.
Glioblastoma (GBM) is the most common and devastating primary malignant brain tumor. We summarize recent advances in radiotherapy, immunotherapy, and targeted therapy approaches for the treatment of newly diagnosed and recurrent glioblastoma. We also introduce ongoing clinical trials.
Recent clinical trials have explored multiple novel strategies to treat GBM including the use of oncoviruses, chimeric antigen receptor (CAR) T cell therapy, vaccines, radiotherapy, and novel drug delivery techniques to improves drug penetrance across the blood brain barrier. Approaches to improve drug delivery to brain tumors have the potential to expand treatment options of existing therapies that otherwise have poor brain tumor penetrance. Immunotherapy has been of keen interest in both newly diagnosed and recurrent glioblastoma. Vaccines SurVaxM and DCVax-L have shown initial promise in phase II and III trials, respectively. CAR T cell therapy trials are in their early phases but hold promise in both newly diagnosed and recurrent glioblastoma.
Although progress to improve outcomes for GBM patients has been modest, multiple novel strategies utilizing combination therapies, focused ultrasound to improve drug delivery, and novel immunotherapies are underway.
胶质母细胞瘤(GBM)是最常见和最具破坏性的原发性恶性脑肿瘤。我们总结了最近在放射治疗、免疫治疗和靶向治疗方面的进展,用于治疗新诊断和复发性胶质母细胞瘤。我们还介绍了正在进行的临床试验。
最近的临床试验探索了多种治疗 GBM 的新策略,包括使用肿瘤病毒、嵌合抗原受体(CAR)T 细胞疗法、疫苗、放射治疗和新型药物输送技术,以提高血脑屏障的药物穿透性。改善药物向脑肿瘤输送的方法有可能扩大现有治疗方法的选择,而这些治疗方法对脑肿瘤的穿透性很差。免疫疗法在新诊断和复发性胶质母细胞瘤中都受到了极大的关注。疫苗 SurVaxM 和 DCVax-L 在 II 期和 III 期试验中分别显示出初步的疗效。CAR T 细胞治疗试验处于早期阶段,但在新诊断和复发性胶质母细胞瘤中都有很大的应用前景。
尽管在提高 GBM 患者的治疗效果方面进展甚微,但仍有多种新策略正在进行,包括联合治疗、聚焦超声以提高药物输送效率以及新型免疫疗法。