Vaccine-Based Immunotherapeutics for the Treatment of Glioblastoma: Advances, Challenges, and Future Perspectives

World Neurosurg. 2018 Dec:120:302-315. doi: 10.1016/j.wneu.2018.08.202. Epub 2018 Sep 6.

Abstract

Glioblastoma is a highly aggressive neoplasm with an extremely poor prognosis. Despite maximal gross resection and chemoradiotherapy, these grade IV astrocytomas consistently recur. Glioblastoma cells exhibit numerous pathogenic mechanisms to decrease tumor immunogenicity while promoting gliomagenesis, which manifests clinically as a median survival of less than 2 years and few long-term survivors. Recent clinical trials of vaccine-based immunotherapeutics against glioblastoma have demonstrated encouraging results in prolonging progression-free survival and overall survival. Several vaccine-based treatments have been trialed, such as peptide and heat-shock proteins, dendritic cell-based vaccines, and viral-based immunotherapy. In this literature review, we discuss the immunobiology of glioblastoma, significant current and completed vaccine-based immunotherapy clinical trials, and broad clinical challenges and future directions of glioblastoma vaccine-based immunotherapeutics.

Keywords: Brain neoplasm; Clinical trials; Glioblastoma; Immunotherapeutic; Immunotherapy; Vaccine.

Publication types

  • Review

MeSH terms

  • Brain / immunology
  • Brain Neoplasms / immunology
  • Brain Neoplasms / mortality
  • Brain Neoplasms / therapy*
  • Clinical Trials as Topic
  • Glioblastoma / immunology
  • Glioblastoma / mortality
  • Glioblastoma / therapy*
  • Humans
  • Immune Privilege / immunology
  • Immune Tolerance / immunology
  • Immunotherapy / methods*
  • Immunotherapy / trends
  • Neoplastic Stem Cells / immunology
  • Progression-Free Survival
  • Tumor Microenvironment / immunology
  • Vaccines / immunology
  • Vaccines / therapeutic use*

Substances

  • Vaccines