Immunotherapy of malignant gliomas: a modern view on the problem

Abstract

Malignant gliomas are one of the most common brain tumors in adults arising from glial cells with an extremely poor prognosis. Generally, therapy of malignant gliomas consists of radical surgical removal followed by radio- and/or chemotherapy. However, prognosis of the disease remains unfavorable.The review presents main clinical, morphological and molecular characteristics of gliomas, their prognostic significance and role in the choice of targeted therapy based on using tyrosine kinase inhibitors and/or monoclonal antibodies. The current aspects of immunotherapy of gliomas (i.e., activation of immune cells, or blockage of immunosuppressive signaling) are discussed in detail. One of the well-known approaches of cancer immunotherapy is based on immune checkpoint inhibitors. These drugs might be effective in treatment of malignant gliomas overexpressing the molecules that suppress immune cells functions. Another promising approach of gliomas immunotherapy is based on genetically modified CAR-T cells (CAR – chimeric antigen receptor) which might identify and eliminate cancer cells. Cytokine therapy is also perspective treatment approach, as well as gene therapy which is associated with editing viral genes for production of oncolytic viruses used as anticancer vaccines. Vaccines are being developed to generate the specific antibodies recognized cancer cells and thereby stimulate the immune system to identify and destroy tumor cells.Despite the promising potential of various gliomas immunotherapy methods, most of them are at different stages of preclinical and clinical trials. Some of them demonstrate promising results and good perspective for the further use to treat glioma patients.