Recent progress in immunotherapy for malignant glioma: treatment strategies and results from clinical trials.
BACKGROUND
Despite advances in surgical and adjuvant radiation therapy and chemotherapy strategies, malignant gliomas continue to be associated with poor prognoses.


METHODS
We review immune-mediated treatment approaches for malignant glioma and the relevance of recent clinical trials and their outcomes. We specifically address the increasing evidence implicating the role of cytotoxic T cells in ensuring adequate immune-mediated clearance of neoplastic cells and the need for the optimization of therapies that can elicit and support such antitumor T-cell activity.


RESULTS
The poor outcome of this disease has spurred the search for novel experimental therapies that can address and overcome the root biological phenomena associated with the lethality of this disease. The use of immunotherapy to bolster the otherwise impaired antitumor immune responses in glioma patients has received increasing attention.


CONCLUSIONS
An effective treatment paradigm for malignant gliomas may eventually require a multifaceted approach combining two or more different immunotherapeutic strategies. Such scenarios may involve the use of local cytokine gene therapy to enhance glioma-cell immunogenicity in conjunction with dendritic cell-based active vaccination to stimulate systemic tumoricidal T-cell immunity. Given the heterogeneity of this disease process and the potential risk of immunoediting out a selected, treatment-refractory tumor cell population, the concurrent use of multiple modalities that target disparate tumor characteristics may be of greatest therapeutic relevance.
Ehtesham
Moneeb
M
Maxine Dunitz Neurosurgical, Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Black
Keith L
KL
Yu
John S
JS
D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000627:therapeutic use; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005910:Glioma / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D007167:Immunotherapy / Q000379:methods*; D016233:Immunotherapy, Active / Q000379:methods; D016219:Immunotherapy, Adoptive / Q000379:methods; D008875:Middle Aged; D019063:Tenascin / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
D016207:Cytokines; D019063:Tenascin; D066246:ErbB Receptors