Glioblastoma and the CAR-T cell therapy: A review

Abstract

Gliomas are the most common and aggressive tumors that develop from the brain. Glioblastomas are also known as grade IV gliomas, indicating them the most aggressive brain tumors. Unlike other cancers that are categorized by stage, gliomas are classified by grade which describes how aggressive the tumor appears under the microscope and its molecular profiles. The grade for gliomas ranges from I to IV, with I is the least aggressive gliomas and IV is the most aggressive one. Glioblastoma originated from glial cells which are a type of brain cells that support and protect brain cells. The common treatments for glioblastomas include surgery, chemotherapy with temozolomide, and radiotherapy. Though patients experience decreases in symptoms and improvement in emotions, the survival rate for the treatments is significantly low. Part of the reason for the situation is the poor efficiency of TMZ due to the medicine penetrating the blood-brain barrier insufficiently. CAR-T cell therapy, an innovative immunotherapy regarded as a self-duplicating drug to treat cancer, is considered to have a better blood-brain barrier penetration, making the therapy a potentially promising treatment for glioblastoma. Besides, the treatment targets and kills tumor cells directly and it is independent of the endogenous immune response, which is greatly repressed in glioblastoma. Unfortunately, due to the restricted number of specific antigens in glioblastoma and their heterogenous expression, results of CART cell therapy for glioblastoma have not indicated clinical benefit. Nevertheless, adjustments can be made in order to improve the CART cell therapy in glioblastoma.