Can Immunotherapy Succeed in Glioblastoma? May 24, 2018, by NCI Staff
Researchers who study glioblastoma have been hopeful that immunotherapy might be able to succeed where other therapies have not. And in laboratory studies and human clinical trials, they are leaving no immunotherapy stone unturned.
Unfortunately, several immune-based treatments that looked highly promising in early-phase studies of patients with glioblastoma have not panned out in larger, phase 3 clinical trials. But even those failures have a silver lining, said Michael Lim, M.D., who directs the Brain Tumor Immunotherapy program at the Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center.
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And then there’s the matter of how the immune system operates in the brain, Dr. Lim said. “We’re understanding now that the immune environment of the brain is very different from other organs,” he explained.
For example, the brain appears to have a different mix of immune cells than other organs (there are many different types of immune cells, each with different responsibilities). For several reasons, Dr. Lim continued, the composition of immune cells in the brain doesn’t readily generate an immune response against tumors the way immune cells in other organs do.
Glioblastoma tumors also seem particularly adept at blunting an immune response. One recently published study, for instance, showed that many of the immune cells in and around glioblastoma tumors tend to be “exhausted”—that is, the molecular machinery the cells need to stimulate their activity is severely impaired.
It would still be a long journey for immunotherapy to succeed in glioblastoma because the tumor microenvironment in glioblastoma is immunosuppressive.
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