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Published on: September 1, 2018
T cell immunity in patients with malignant glioma: recent progress in dendritic cell-based immunotherapeutic
Yasuharu Akasaki1, Keith L Black, John S Yu
1Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Abstract:
Despite dramatic advances in surgical technique, imaging, and adjuvant radiotherapy or chemotherapy, the prognosis for patients with malignant glial tumors remains dismal. Based on the current knowledge regarding immune responses in the healthy central nervous system (CNS) and glioma-bearing hosts, we discuss dendritic cell (DC)-based immunotherapeutic approaches for malignant gliomas and the relevance of recent clinical trials and their outcomes. It is now recognized that the CNS is not an immunologically tolerated site, and clearance of arising glioma cells is a routine physiological function of the normal, non-compromised immune system. To escape from immune surveillance, however, clinically apparent gliomas develop complex mechanisms that suppress tumoricidal immune responses. Although the use of DCs for the treatment of glioma patients may be the most appropriate approach, an effective treatment paradigm for these tumors may eventually require the use of several types of treatment. Additionally, given the heterogeneity of this disease process and an immune-refractory tumor cell population, the series use of rational multiple modalities that target different tumor characteristics may be the most effective therapeutic strategy to treat malignant gliomas.
Insights
Dendritic cell (DC) immunotherapy shows promise for malignant gliomas, but overcoming immune suppression is key. Combining DC vaccines with other therapies may offer the most effective strategy for these challenging brain tumors.
Area of Science:
- Neuro-oncology
- Immunology
- Cancer Therapy
Background:
- Malignant gliomas have a poor prognosis despite advances in conventional treatments.
- The central nervous system (CNS) is not inherently immune-privileged; the immune system normally clears nascent glioma cells.
- Gliomas develop sophisticated mechanisms to evade immune surveillance and suppress anti-tumor immune responses.
Purpose of the Study:
- To review dendritic cell (DC)-based immunotherapeutic strategies for malignant gliomas.
- To discuss the immunological basis for DC therapy in the context of CNS immune responses.
- To evaluate the outcomes of recent clinical trials involving DC-based treatments for gliomas.
Main Methods:
- Review of current literature on CNS immunity and glioma immune evasion.
- Analysis of clinical trial data for dendritic cell-based immunotherapies in glioma patients.
- Discussion of the immunological principles underlying DC function in cancer treatment.
Main Results:
- Dendritic cells (DCs) are recognized as a potentially suitable immunotherapy for glioma.
- Glioma cells employ complex strategies to suppress immune responses, hindering effective clearance.
- Clinical trial outcomes highlight the need for optimized DC-based approaches and combination therapies.
Conclusions:
- Dendritic cell (DC)-based immunotherapy is a promising avenue for malignant gliomas.
- Addressing immune suppression and tumor heterogeneity is crucial for therapeutic success.
- A multi-modal treatment strategy, potentially combining DC vaccines with other therapies, is likely necessary for effective glioma treatment.
