Immunotherapy of gliomas

Abstract

There has been little change in the average survival of patients with malignant glioma these past two decades, despite extensive treatment including surgical resection, radiotherapy and chemotherapy. Immunotherapy has attracted the attention of many investigators as a new adjuvant therapy, but early approaches were largely unsuccessful. This seems to have been related to the immunological microenvironment within the central nervous system in which the blood brain barrier exists, and where no dendritic cells, potent antigen-presenting cells, are distributed. Furthermore, the immunobiological characters of glioma, which have many mechanisms to escape host's immnological surveillance, are the reason for the difficulty of immunotherapy. However, the modem advanced understanding of immunology and molecular biology has yielded novel immunostimulatory strategies such as immunogene therapy and dendritic cell manipulations, which have caused dramatic preclinical results in glioma models. Although definitive clinical results and solutions to side effects remain to be seen, immunotherapy shows great promise for the future.