Prognostic role of tumour-infiltrating inflammatory cells in brain tumours: literature review.

Abstract

Both primary and metastatic brain tumours pose a significant and unmet clinical need. Immune cells infiltrating the tumour have been shown to affect the clinical course of various extracranial tumour types, but there is little knowledge on the role of tumour-infiltrating immune cells in brain tumours. Thus, the aim of this review was to recapitulate the reports on immune infiltrates in brain tumours and their prognostic significance. Immune infiltrates composed of various lymphocyte subsets and microglia/macrophages are frequently observed in brain tumours; however, their density and prognostic role seem to differ between tumour types. Central nervous system (CNS) metastases, particularly of melanoma, lung cancer and renal cell cancer, commonly show high amounts of tumour-infiltrating lymphocytes and tumour-infiltrating lymphocytes density strongly correlate with patient's overall survival times in patients with CNS metastases. In gliomas and primary CNS lymphomas, some studies also suggest a prognostic role of immune cell infiltration; however, methodological issues such as low sample size and retrospective study designs with heterogeneous patient populations preclude definite conclusions. Meningiomas typically harbour inflammatory infiltrates, but their correlation with the clinical course is unclear because of the lack of studies correlating immune cell infiltrates with outcome parameters. The available literature suggests a relevant role of immune infiltrates in the clinical course of some brain tumour types; however, further studies are required to better understand the interaction of the immune system and CNS neoplasms and to explore therapeutic opportunities with immunotherapies such as vaccines or immune checkpoint modulators.