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Published on: September 1, 2018
Active immunotherapy using dendritic cells in the treatment of glioblastoma multiforme
Amade Bregy1, Theresa M Wong, Ashish H Shah
1University of Miami Miller School of Medicine, Department of Neurological Surgery, Miami, FL, USA.
Objective:
Glioblastoma multiforme, the most common malignant brain tumor still has a dismal prognosis with conventional treatment. Therefore, it is necessary to explore new and/or adjuvant treatment options to improve patient outcomes. Active immunotherapy is a new area of research that may be a successful treatment option. The focus is on vaccines that consist of antigen presenting cells (APCs) loaded with tumor antigen. We have conducted a systematic review of prospective studies, case reports and clinical trials. The goal of this study was to examine the efficacy and safety in terms of complications, median overall survival (OS), progression free survival (PFS) and quality of life.
Methods:
A PubMed search was performed to include all relevant studies that reported the characteristics, outcomes and complications of patients with GBM treated with active immunotherapy using dendritic cells. Reported parameters were immune response, radiological findings, median PFS and median OS. Complications were categorized based on association with the craniotomy or with the vaccine itself.
Results:
A total of 21 studies with 403 patients were included in our review. Vaccination with dendritic cells (DCs) loaded with autologous tumor cells resulted in increased median OS in patients with recurrent GBM (71.6-138.0 wks) as well as those newly diagnosed (65.0-230.4 wks) compared to average survival of 58.4 wks.
Conclusions:
Active immunotherapy, specifically with autologous DCs loaded with autologous tumor cells, seems to have the potential of increasing median OS and prolonged tumor PFS with minimal complications. Larger clinical trials are needed to show the potential benefits of active immunotherapy.
Insights
Active immunotherapy using autologous dendritic cells (DCs) loaded with tumor cells shows promise for glioblastoma treatment. This approach may improve overall survival and progression-free survival with minimal side effects.
Area of Science:
- Neuro-oncology
- Immunotherapy
- Cancer Vaccines
Background:
- Glioblastoma multiforme (GBM) has a poor prognosis with standard treatments.
- Novel therapeutic strategies are crucial for improving patient outcomes.
- Active immunotherapy, particularly with antigen-presenting cells, is an emerging treatment avenue.
Purpose of the Study:
- To systematically review the efficacy and safety of active immunotherapy using dendritic cells (DCs) in glioblastoma patients.
- To evaluate outcomes including overall survival (OS), progression-free survival (PFS), and quality of life.
- To assess complications associated with this treatment modality.
Main Methods:
- A systematic literature search was conducted on PubMed for studies on GBM treated with active immunotherapy using DCs.
- Included were prospective studies, case reports, and clinical trials.
- Data on immune response, radiological findings, PFS, OS, and complications were extracted and analyzed.
Main Results:
- Twenty-one studies involving 403 patients were reviewed.
- Vaccination with autologous tumor cell-loaded DCs demonstrated increased median OS in both recurrent (71.6-138.0 wks) and newly diagnosed (65.0-230.4 wks) GBM patients compared to the average survival of 58.4 wks.
- The treatment showed potential for prolonged PFS.
Conclusions:
- Active immunotherapy with autologous tumor cell-loaded DCs appears to enhance median OS and prolong PFS in GBM patients.
- This therapeutic approach presents minimal complications.
- Larger clinical trials are warranted to confirm the benefits of active immunotherapy for glioblastoma.
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