PURPOSE Immunotherapy, activation of the immune system to target tumor cells, represents a paradigm shift in the treatment of cancer. Immune checkpoint therapies, which target immunomodulatory molecules expressed on T-lymphocytes, have demonstrated improved survival in a variety of malignancies. However, benefit in glioblastoma, the most common and devastating malignant brain tumor, remains to be seen. With several recent clinical trials failing to show efficacy of immunotherapy, concerns have been raised regarding the impact of glucocorticoid use in this patient population that may impair the ability for immune checkpoint inhibitors to affect a response. METHODS For this article we examined the mechanism by which immune checkpoint inhibitors activate, and glucocorticoids impair, T-lymphocyte function. RESULTS In this context, we review the clinical data of immune checkpoint inhibitors in glioblastoma as well as the impact glucocorticoids have on immune checkpoint inhibitor efficacy. Finally, we highlight key questions that remain in the field, and the potential benefit of further research for central nervous system tumors. CONCLUSION More information on the extent, character and duration of glucocorticoids on patients treated with PD-(L)1 will better inform both clinical management and novel therapeutic development of immunotherapy in patients with CNS malignancies.

中文翻译：

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胶质母细胞瘤中的糖皮质激素和免疫检查点抑制剂。

目的免疫疗法，即激活免疫系统以靶向肿瘤细胞，代表了癌症治疗的范式转变。以 T 淋巴细胞上表达的免疫调节分子为目标的免疫检查点疗法已证明可以提高多种恶性肿瘤的存活率。然而，胶质母细胞瘤是最常见和最具破坏性的恶性脑肿瘤，其疗效仍有待观察。由于最近的几项临床试验未能显示免疫疗法的疗效，人们担心糖皮质激素在该患者群体中的使用可能会损害免疫检查点抑制剂影响反应的能力。方法 在本文中，我们研究了免疫检查点抑制剂激活和糖皮质激素损害 T 淋巴细胞功能的机制。结果 在这种情况下，我们回顾了胶质母细胞瘤中免疫检查点抑制剂的临床数据以及糖皮质激素对免疫检查点抑制剂疗效的影响。最后，我们强调了该领域的关键问题，以及进一步研究中枢神经系统肿瘤的潜在益处。结论 更多关于接受 PD-(L)1 治疗的患者的糖皮质激素的程度、特征和持续时间的信息将更好地为 CNS 恶性肿瘤患者的临床管理和免疫疗法的新治疗开发提供信息。