Abstract
Glioblastoma (GBM) is the most devastating brain tumor, with associated poor prognosis. Despite advances in surgery and chemoradiation, the survival of afflicted patients has not improved significantly in the past three decades. Immunotherapy has been heralded as a promising approach in treatment of various cancers; however, the immune privileged environment of the brain usually curbs the optimal expected response in central nervous system malignancies. In addition, GBM cells create an immunosuppressive microenvironment and employ various methods to escape immune surveillance. The purpose of this review is to highlight the strategies by which GBM cells evade the host immune system. Further understanding of these strategies and the biology of this tumor will pave the way for developing novel immunotherapeutic approaches for treatment of GBM.
Highlights
One of the challenges scientists face in the treatment of glioblastoma (GBM) is suboptimal responses to immunotherapy [1, 2]
Upon chemoattraction into the tumor environment [47, 49, 123, 124] with a high concentration of colony-stimulating factor-1 (CSF-1), TGFβ1, macrophage inhibitory cytokine-1 (MIC-1), and IL-10, tumor-associated macrophages (TAMs) are polarized toward the M2 phenotype, subsequently inhibiting their phagocytic ability and enhancing their capacity to inhibit cytotoxic T-cell proliferation and increase the effect of Tregs [36]
The interaction of GBM with the immune system is intricate at every level
Summary
One of the challenges scientists face in the treatment of glioblastoma (GBM) is suboptimal responses to immunotherapy [1, 2]. Stagnation in the treatment of GBM is attributable to different challenges in therapy and our poor understating of both tumor biology and interactions with its microenvironment. With the introduction of immunotherapy as a novel and promising approach to cancer treatment, new hopes are raised for the management of brain tumors. This article aims to review the mechanisms employed by GBM cells to suppress and evade the body’s immune responses.
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