Active Immunotherapy for Glioblastoma Treatment: A Systematic Review and Meta-Analysis

Abstract

Introduction Glioblastoma multiforme (GBM) makes 60–70% of gliomas and 15% of primary brain tumors. Despite the availability of standard multimodal therapy, 2 years, 3 years, and 5 years survival rate of GBM are still low. Active immunotherapy is a relatively new treatment option for GBM that seems promising. Methods An electronic database search on PubMed, Cochrane, Scopus, and clinicaltrials.gov was performed to include all relevant studies. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Reported parameters are OS, PFS, AEs, post treatment KPS, and 2 year mortality. Results Active immunotherapy provided better OS (HR = .85; 95% CI = .71–1.01; P = .06) and PFS (HS = .83; 95% CI= .66 – 1.03; P = .11) side albeit not statistically significant. Active immunotherapy reduces the risk of 2 year mortality as much as 2.5% compared to control group (NNT and RRR was 56.7078 and 0,0258, respectively). Conclusion Active immunotherapy might be beneficial in terms of survival rate in patients with GBM although not statistically significant. It could be a treatment option for GBM in the future.

Enhancing cancer immunotherapy with photodynamic therapy and nanoparticle: making tumor microenvironment hotter to make immunotherapeutic work better

“…Unfortunately, all immunotherapies tested to date have failed to improve clinical outcomes in unselected cohorts of patients with GBM (102). In a recent meta-analysis, the active immunotherapy of GBM reduced the risk of 2-year mortality by as much as 2.5% compared to the control group (103). Cancer cells undergoing ICD by appropriate PDT should potentially activate autologous DCs by providing highly immunogenic tumor antigens and strong DAMP signals.…”

NCDN is a Potential Biomarker and Therapeutic Target for Glioblastoma

“…In order to improve the prognosis for patients with GBM, many teams have tried to find new treatments, including monoclonal antibodies, small molecule inhibitors and cancer vaccines [9,10]. Meanwhile, emerging tumor inhibitors targeting DNA damage/repair pathways, tumor suppressor protein p53, growth factor receptors, cell cycle control Ivyspring International Publisher enzymes/genes, and their downstream pathways, are used as alternative/supplementary anti-cancer strategies.…”

Understanding the glioblastoma tumor microenvironment: leveraging the extracellular matrix to increase immunotherapy efficacy

“…Many of these therapies are becoming the additional pillar of cancer treatment by supplementing surgery, radiotherapy, chemotherapy, and targeted therapy (5). However, GBM has not benefitted from these advancements; immunotherapies such as dendritic cell vaccines, chimeric antigen receptor T cell therapy, and several checkpoint inhibitors have not delivered the expected outcomes, as they fail to show a clear survival benefit in clinical trials with high inter-patient variability (6)(7)(8)(9)(10). The failure of these therapies is attributed to the highly spatiotemporally heterogeneous and immunosuppressive TME (11).…”