Introduction

Glioblastoma is a very aggressive cancer with dismal prognosis despite standard of care including surgical resection, radiation therapy, and chemotherapy. There is interest in applying immunotherapy to glioblastoma as this modality has demonstrated remarkable improvements in the management of several solid tumors including melanoma, renal cell carcinoma, and non-small cell lung cancer. This review aims to provide an overview of the current state of glioblastoma immunotherapy.

Methods

Literature search was performed on PubMed between 1961 and 2020.

Results

Initial clinical trials of checkpoint inhibitors and vaccine therapy for glioblastoma have largely been disappointing for both primary and recurrent glioblastoma. This failure has been attributed to glioblastoma’s highly immunosuppressive environment and multiple mechanisms of therapy resistance including high tumor heterogeneity, low mutational burden, systemic immunosuppression, and local immune dysfunction.

Conclusions

Current clinical trials are exploring combination therapy and novel treatment strategies beyond immune checkpoint therapies and vaccine therapy such as CAR T cells. There is also an effort to establish synergy between immunotherapy and current standard of care. Furthermore, recent advances in personalized neoantigen vaccines suggest a shift towards personalized, patient-specific GBM treatment.

中文翻译：

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胶质母细胞瘤免疫治疗综述。

介绍

胶质母细胞瘤是一种侵袭性很强的癌症，尽管有标准的护理，包括手术切除、放射治疗和化学疗法，但预后不佳。将免疫疗法应用于胶质母细胞瘤引起了人们的兴趣，因为这种方式已在多种实体瘤（包括黑色素瘤、肾细胞癌和非小细胞肺癌）的治疗中表现出显着改善。本综述旨在概述胶质母细胞瘤免疫治疗的现状。

方法

1961 年至 2020 年间在 PubMed 上进行了文献检索。

结果

对于原发性和复发性胶质母细胞瘤，检查点抑制剂和胶质母细胞瘤疫苗治疗的初步临床试验在很大程度上令人失望。这种失败归因于胶质母细胞瘤的高度免疫抑制环境和多种治疗抵抗机制，包括高肿瘤异质性、低突变负荷、全身免疫抑制和局部免疫功能障碍。

结论

目前的临床试验正在探索除免疫检查点疗法和疫苗疗法（如 CAR T 细胞）之外的联合疗法和新的治疗策略。还努力在免疫疗法和当前护理标准之间建立协同作用。此外，个性化新抗原疫苗的最新进展表明向个性化、患者特异性 GBM 治疗转变。