Immunotherapy for primary brain tumors: no longer a matter of privilege.
Immunotherapy for cancer continues to gain both momentum and legitimacy as a rational mode of therapy and a vital treatment component in the emerging era of personalized medicine. Gliomas, and their most malignant form, glioblastoma, remain as a particularly devastating solid tumor for which standard treatment options proffer only modest efficacy and target specificity. Immunotherapy would seem a well-suited choice to address such deficiencies given both the modest inherent immunogenicity of gliomas and the strong desire for treatment specificity within the confines of the toxicity-averse normal brain. This review highlights the caveats and challenges to immunotherapy for primary brain tumors, as well as reviewing modalities that are currently used or are undergoing active investigation. Tumor immunosuppressive countermeasures, peculiarities of central nervous system immune access, and opportunities for rational treatment design are discussed.
Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Peter E
PE
Fecci
Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Amy B
AB
Heimberger
Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina. john.sampson@duke.edu.
John H
JH
Sampson
D001932:Brain Neoplasms / Q000276:immunology* / Q000628:therapy*; D002986:Clinical Trials as Topic; D005909:Glioblastoma / Q000276:immunology / Q000628:therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D012107:Research Design; D057170:Translational Research, Biomedical; D016896:Treatment Outcome