Glioma immunology and immunotherapy

OBJECTIVE: Despite advances in conventional therapy, the prognosis for most glioma patients remains dismal. This has prompted an intensive search for effective treatment alternatives. Immunotherapy, one such alternative, has long been recognized as a potentially potent cancer treatment but has been limited by an inadequate understanding of the immune system. Now, increased insight into immunology is suggesting more rational approaches to immunoth erapy. In this article, we explore key aspects of modern immunology and dis cuss their implications for glioma therapy. METHODS: A thorough literature review of glioma immunology and immunotherap y was undertaken to inquire into the basic immunology, central nervous syst em immunology, glioma immunobiology, standard glioma immunotherapy, and rec ent immunotherapeutic advances in glioma treatment. RESULTS: Although gliomas express tumor-associated antigens and appear pote ntially sensitive to immune responses, many factors work together to inhibi t antiglioma immunity. Not surprisingly, most clinical attempts at glioma i mmunotherapy have met with little success to date. However, novel immunosti mulatory strategies, such as immunogene therapy, directed cytokine delivery , and dendritic cell manipulation, have recently yielded dramatic preclinic al results in glioma models. This suggests that glioma-derived immunosuppre ssion can be overcome. CONCLUSION: Modern molecular biology and immunology techniques have yielded a wealth of new data about glioma immunobiology. Armed with this informati on, many investigators have proposed novel means to stimulate antiglioma im mune responses, Although definitive clinical results remain to be seen, the current renaissance in glioma immunology and immunotherapy shows great pro mise for the future.