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多形性胶质母细胞瘤 (GBM) 治疗的实用免疫调节全景。

Practical immunomodulatory landscape of glioblastoma multiforme (GBM) therapy.

机构信息

Cancer Research Center and, Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran.

Department of Hematology and Oncology, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

J Egypt Natl Canc Inst. 2024 Oct 28;36(1):33. doi: 10.1186/s43046-024-00240-4.

Abstract

Glioblastoma multiforme (GBM) is the most common harmful high-grade brain tumor with high mortality and low survival rate. Importantly, besides routine diagnostic and therapeutic methods, modern and useful practical techniques are urgently needed for this serious malignancy. Correspondingly, the translational medicine focusing on genetic and epigenetic profiles of glioblastoma, as well as the immune framework and brain microenvironment, based on these challenging findings, indicates that key clinical interventions include immunotherapy, such as immunoassay, oncolytic viral therapy, and chimeric antigen receptor T (CAR T) cell therapy, which are of great importance in both diagnosis and therapy. Relatively, vaccine therapy reflects the untapped confidence to enhance GBM outcomes. Ongoing advances in immunotherapy, which utilizes different methods to regenerate or modify the resistant body for cancer therapy, have revealed serious results with many different problems and difficulties for patients. Safe checkpoint inhibitors, adoptive cellular treatment, cellular and peptide antibodies, and other innovations give researchers an endless cluster of instruments to plan profoundly in personalized medicine and the potential for combination techniques. In this way, antibodies that block immune checkpoints, particularly those that target the program death 1 (PD-1)/PD-1 (PD-L1) ligand pathway, have improved prognosis in a wide range of diseases. However, its use in combination with chemotherapy, radiation therapy, or monotherapy is ineffective in treating GBM. The purpose of this review is to provide an up-to-date overview of the translational elements concentrating on the immunotherapeutic field of GBM alongside describing the molecular mechanism involved in GBM and related signaling pathways, presenting both historical perspectives and future directions underlying basic and clinical practice.

摘要

胶质母细胞瘤(GBM)是最常见的致命性高级别脑肿瘤,死亡率和存活率都很低。重要的是,除了常规的诊断和治疗方法外,这种严重的恶性肿瘤还迫切需要现代和有用的实用技术。相应地,基于这些具有挑战性的发现,专注于胶质母细胞瘤的遗传和表观遗传特征、免疫框架和大脑微环境的转化医学表明,关键的临床干预措施包括免疫疗法,如免疫测定、溶瘤病毒治疗和嵌合抗原受体 T 细胞(CAR T)治疗,这在诊断和治疗中都非常重要。相对而言,疫苗疗法反映了增强 GBM 治疗效果的未开发信心。正在进行的免疫疗法进展利用不同的方法来再生或修饰抵抗癌症的身体,已经取得了重要的结果,但也为患者带来了许多不同的问题和困难。安全的检查点抑制剂、过继性细胞治疗、细胞和肽抗体以及其他创新为研究人员提供了一系列用于个性化医学和联合技术潜力的工具。通过这种方式,阻断免疫检查点的抗体,特别是针对程序性死亡 1(PD-1)/PD-1(PD-L1)配体途径的抗体,改善了广泛疾病的预后。然而,其与化疗、放疗或单药治疗联合使用在治疗 GBM 方面无效。本综述的目的是提供一个关于胶质母细胞瘤免疫治疗领域的最新概述,同时描述涉及胶质母细胞瘤的分子机制及相关信号通路,呈现基础和临床实践的历史观点和未来方向。

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