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A review of glioblastoma immunotherapy

  • Topic Review
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Introduction

Glioblastoma is a very aggressive cancer with dismal prognosis despite standard of care including surgical resection, radiation therapy, and chemotherapy. There is interest in applying immunotherapy to glioblastoma as this modality has demonstrated remarkable improvements in the management of several solid tumors including melanoma, renal cell carcinoma, and non-small cell lung cancer. This review aims to provide an overview of the current state of glioblastoma immunotherapy.

Methods

Literature search was performed on PubMed between 1961 and 2020.

Results

Initial clinical trials of checkpoint inhibitors and vaccine therapy for glioblastoma have largely been disappointing for both primary and recurrent glioblastoma. This failure has been attributed to glioblastoma’s highly immunosuppressive environment and multiple mechanisms of therapy resistance including high tumor heterogeneity, low mutational burden, systemic immunosuppression, and local immune dysfunction.

Conclusions

Current clinical trials are exploring combination therapy and novel treatment strategies beyond immune checkpoint therapies and vaccine therapy such as CAR T cells. There is also an effort to establish synergy between immunotherapy and current standard of care. Furthermore, recent advances in personalized neoantigen vaccines suggest a shift towards personalized, patient-specific GBM treatment.

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Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 123, Baltimore, MD, 21287, USA

    Ravi Medikonda & Michael Lim

  2. Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

    Gavin Dunn

  3. Department of Neurosurgery, University of Florida, Gainesville, FL, USA

    Maryam Rahman

  4. Department of Neurosurgery, Duke University Hospital, Durham, NC, USA

    Peter Fecci

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  1. Ravi Medikonda
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  2. Gavin Dunn
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  3. Maryam Rahman
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  4. Peter Fecci
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  5. Michael Lim
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Correspondence to Michael Lim.

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The corresponding author receives research support from Arbor, BMS, Accuray, DNAtrix, Tocagen, Biohaven, and Kyrin-Kyowa. He is a consultant for Tocagen, VBI, and Stryker.

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Medikonda, R., Dunn, G., Rahman, M. et al. A review of glioblastoma immunotherapy. J Neurooncol 151, 41–53 (2021). https://doi.org/10.1007/s11060-020-03448-1

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