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Immunotherapeutic strategies for glioma treatment

George A. Alexiou , Athanassios P. Kyritsis 1,2
1
1 Neurosurgical Research Institute, University of Ioannina, 45110 Ioannina, Greece.
2 Department of Neurology, University Hospital of Ioannina, 45110 Ioannina, Greece.

Dr. George A. Alexiou is a Neurosurgeon working at the Neurosurgical Research Institute of the University of Ioannina in
Greece. His main research interests are in Neuro-oncolgy, new treatments for brain tumours and Pediatric Neurosurgery.

A B S T R AC T
Glioblastoma is the most common and malignant primary brain tumor. Despite intensive clinical investigation and several
novel therapeutic approaches, the median survival continues to remain poor and it is usually in the range of fifteen months.
Immunotherapy is a beacon of hope for cancer treatment and offers a different approach against glioma. Various approaches have
been used, such as dendritic cell based vaccines, peptide vaccines, T-cell-based therapies and immune checkpoint blockade
with promising results. This paper provided an overview of the results of the most exciting immune therapeutic strategies for the
treatment of gliomas.

Key words: Glioma; immunotherapy; vaccines

INTRODUCTION is characterized by alterations of Platelet Derived
Growth Factor A and point mutations in cytosolic
Glioblastoma (GBM) is by far the most common type isocitrate dehydrogenase. A clinical significance was
of primary brain tumor in adults. This devastating also reported, concluding that therapeutic approaches
disease is usually incurable and virtually all GBM need to be GBM subtype-specific. [3]
patients succumb despite treatments that consist
of surgery, radiotherapy and chemotherapy. The Immunotherapy is an attractive treatment option
median survival time remains in the range of 15 that involves the stimulation of patient’s immune
months. [1,2] GBM is an heterogenous tumor and there system against cancer cells with high specificity
[4]
is great variability regarding response to treatment and minimal toxicity. In the late 1800s, William B.
[3]
and outcome. Verhaak et al. developed a molecular Coley, a pioneer in immunotherapy, was the first who
classification of GBM into Classical, Mesenchymal, injected a mixture of live streptococcus bacilli and
Proneural and Neural subtypes based on gene subsequently heat-killed streptococcus into sarcomas
[5]
expression. Epidermal Growth Factor Receptor and induced regression of these tumors. GBM cases
amplification and the absence of p53 mutations of increased survival after bacterial infection have
characterize the Classical subtype, whereas the been documented, whereas patients with neutrophil
Mesenchymal subtype is characterized by deletions to lymphocyte ratio in the blood that exceeded 4.7
or mutation of the gene and the Proneural subtype differ significantly from those with neutrophil to
lymphocyte ratio lower than 4.7 and were associated
Corresponding Author: Dr. George A. Alexiou, Neurosurgical with worse survival. [6,7] Nevertheless, GBM can evade
Research Institute, University of Ioannina, 45110 Ioannina, by several mechanisms immune surveillance, such
Greece. E-mail: alexiougrg@yahoo.gr
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DOI: Cite this article as: Alexiou GA, Kyritsis AP. Immunotherapeutic strategies
10.20517/2347-8659.2015.45 for glioma treatment. Neuroimmunol Neuroinflammation 2016;3:51-6.
Received: 15-10-2015; Accepted: 05-01-2016

© 2016 Neuroimmunology and Neuroinflammation | Published by OAE Publishing Inc. 51