Immunotherapy is a promising new therapeutic field that has demonstrated significant benefits in many solid-tumor malignancies, such as metastatic melanoma and non-small cell lung cancer. However, only a subset of these patients responds to treatment. Glioblastoma (GBM) is the most common malignant primary brain tumor with a poor prognosis of 14.6 months and few treatment advancements over the last 10 years. There are many clinical trials testing immune therapies in GBM, but patient responses in these studies have been highly variable and a definitive benefit has yet to be identified. Biomarkers are used to quantify normal physiology and physiological response to therapies. When extensively characterized and vigorously validated, they have the potential to delineate responders from non-responders for patients treated with immunotherapy in malignancies outside of the central nervous system (CNS) as well as GBM. Due to the challenges of current modalities of radiographic diagnosis and disease monitoring, identification of new predictive and prognostic biomarkers to gauge response to immune therapy for patients with GBM will be critical in the precise treatment of this highly heterogenous disease. This review will explore the current and future strategies for the identification of potential biomarkers in the field of immunotherapy for GBM, as well as highlight major challenges of adapting immune therapy for CNS malignancies.
Emerging evidence is demonstrating the extent of T‐cell infiltration within the tumor microenvironment has favorable prognostic and therapeutic implications. Hence, immunotherapeutic strategies that augment the T‐cell signature of tumors hold promising therapeutic potential. Recently, immunotherapy based on intratumoral injection of mannan‐BAM, toll‐like receptor ligands and anti‐CD40 antibody (MBTA) demonstrated promising potential to modulate the immune phenotype of injected tumors. The strategy promotes the phagocytosis of tumor cells to facilitate the recognition of tumor antigens and induce a tumor‐specific adaptive immune response. Using a syngeneic colon carcinoma model, MBTA's potential to augment CD8+ T‐cell tumor infiltrate when administered intratumorally or subcutaneously is demonstrated as part of a whole tumor cell vaccine. Both immunotherapeutic strategies prove effective at controlling tumor growth, prolong survival, and induce immunological memory against the parental cell line. Collectively, the investigation demonstrates MBTA's potential to trigger a potent anti‐tumor immune response.
Preclinical models that reliably recapitulate the immunosuppressive properties of human gliomas are essential to assess immune-based therapies. GL261 murine glioma cells are widely used as a syngeneic animal model of glioma, however, it has become common practice to transfect these cells with luciferase for fluorescent tumor tracking. The aim of this study was to compare the survival of mice injected with fluorescent or non-fluorescent GL261 cells and characterize the differences in their tumor microenvironment. Mice were intracranially implanted with GL261, GL261 Red-FLuc or GL261-Luc2 cells at varying doses. Cytokine profiles were evaluated by proteome microarray and Kaplan-Meier survival analysis was used to determine survival differences. Median survival for mice implanted with 5 × 10 4 GL261 cells was 18 to 21 days. The GL261 Red-FLuc implanted mice cells did not reach median survival at any tumor dose. Mice injected with 3 × 10 5 GL261-Luc2 cells reached median survival at 23 days. However, median survival was significantly prolonged to 37 days in mice implanted with 5 × 10 4 GL261-Luc2 cells. Additionally, proteomic analyses revealed significantly elevated inflammatory cytokines in the supernatants of the GL261 Red-FLuc cells and GL261-Luc2 cells. Our data suggest that GL261 Red-FLuc and GL261-Luc2 murine models elicit an anti-tumor immune response by increasing pro-inflammatory modulators. Glioblastoma (GBM) is the most common malignant primary brain tumor in adults 1. Despite ongoing studies and numerous clinical trials, the prognosis remains poor 2. There is an urgent need to provide these patients with new therapies, as the standard of care treatment has gone unchanged for more than a decade 3. In light of the promising advances made in the area of immune therapy as a treatment for various solid cancers 4-7 , the field of neuro-oncology has embraced immunotherapies for gliomas as a promising area of preclinical and clinical investigation 8. However, recent trials like the Phase III CheckMate-143 9 and Phase III CheckMate-498 10 show poor efficacy despite promising results from pre-clinical studies 11-15. The lack of translation from preclinical to clinical studies illustrates the need for a more rigorous characterization of the pre-clinical models currently being used in the scientific community. The development of novel immune therapeutics is not possible without a reliable preclinical animal model that accurately mimics the complex immune landscape of GBM. Of the various classes of preclinical mouse models, syngeneic models have been indispensable for evaluating immune therapies in GBM 16. Syngeneic murine models are models that rely on allografts of immortalized cancer cells from the same mouse strain from which the model originates.
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