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高级别胶质瘤的免疫治疗与靶向治疗:当前与未来方向

英文原题:Immunotherapy and targeted therapy for high grade gliomas: current and future directions.

PubMed 2025/12/09(内容时间) J Neurooncol Q2 · IF 3.4(JCR 2025)

研究概要

高级别胶质瘤是一种网络性疾病,涉及众多相互关联的分子和微环境现象,从肿瘤内在通路和抗原性到免疫识别与攻击,再到神经元对肿瘤和免疫信号的调控。新兴疗法通常同时利用其中若干交叉机制,为这些毁灭性癌症的未来临床治疗带来了希望。不适用。

研究思路结论见上方概要

高级别胶质瘤是侵袭性内在脑肿瘤,治疗选择有限,预后普遍较差。近年来,在理解高级别胶质瘤的遗传和分子基础及其与肿瘤微环境(包括血管系统、免疫细胞、神经元和胶质细胞)的相互作用方面取得了重大进展,并因此推动了新型分子靶向疗法和免疫疗法的发展。

在此,我们回顾了高级别胶质瘤新治疗策略临床开发的正在进行的工作,讨论了当前面临的挑战,并强调了靶向干预的新兴机遇,特别关注近期和正在进行的临床试验中的分子靶向治疗和免疫治疗。

我们讨论高级别胶质瘤中的相关分子靶点,包括IDH、VEGF、RTK信号通路(EGFR、PI3K/Akt、Ras/Raf/MEK)、p53、CDKN2A/B、CDK4/6、MGMT、PARP、TERT和ATRX,以及当代免疫治疗策略,包括免疫检查点抑制(包括经典和新兴靶点)、细胞免疫治疗(CAR-T细胞、TCR治疗、TIL治疗和其他工程化细胞治疗)、癌症疫苗、溶瘤病毒,以及新兴机制包括基于癌症神经科学的治疗。

展开英文摘要原文

BACKGROUND: High grade gliomas are aggressive intrinsic brain tumors with limited treatment options and a universally poor prognosis. In recent years, significant progress has been made in understanding the genetic and molecular underpinnings of high grade gliomas and their interactions with the tumor microenvironment, including vasculature, immune cells, neurons, and glia, and, consequently, in the development of novel molecularly targeted therapies and immunotherapies. METHODS: Here, we review ongoing work in the clinical development of new therapeutic strategies for high grade gliomas, discuss ongoing challenges, and highlight emerging opportunities for targeted intervention, with particular focus on molecularly targeted and immunotherapy in recent and ongoing clinical trials. RESULTS: We discuss relevant molecular targets in high grade glioma, including IDH, VEGF, RTK signaling (EGFR, PI3K/Akt, Ras/Raf/MEK), p53, CDKN2A/B, CDK4/6, MGMT, PARP, TERT, and ATRX, as well as contemporary immunotherapeutic strategies including immune checkpoint inhibition (including classical and emerging targets), cell-based immunotherapy (CAR-T cells, TCR therapy, TIL therapy, and other engineered cell therapies), cancer vaccines, oncolytic viruses, as well as emerging mechanisms including cancer neuroscience-based therapies. CONCLUSIONS: High grade glioma is a networked disease, involving numerous interconnected molecular and microenvironmental phenomena from tumor-intrinsic pathways and antigenicity to immune recognition and attack to neuronal modulation of both tumor and immune signaling. Emerging therapies harness several of these intersectional mechanisms, often simultaneously, and together offer hope for the future of clinical treatment of these devastating cancers. Not applicable.

论文信息

作者
Hsueh B、Steuart SJ、Odukoya AO、Prager BC、Kim YJ、Hill CM、Choi BD、Dunn GP
第一作者单位
Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.United States
通讯作者单位
Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA. gpdunn@mgh.harvard.edu.United States
文献类型
综述
期刊
Journal of neuro-oncology2025 Dec 9
原文标识
PubMed 41366148 · DOI 10.1007/s11060-025-05315-3