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重新认识胶质母细胞瘤免疫治疗:克服多维耐药的四大支柱框架

英文原题:Reconceptualizing glioblastoma immunotherapy: a four-pillar framework to overcome multidimensional resistance.

查看英文原题

Reconceptualizing glioblastoma immunotherapy: a four-pillar framework to overcome multidimensional resistance.

PubMed 2026/06/17(内容时间) Front Med (Lausanne) Q1 · IF 3.6(JCR 2025)

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中文摘要

胶质母细胞瘤(GBM)仍是一种难治性原发性脑恶性肿瘤,其特征包括显著的免疫抑制性肿瘤微环境(TME)、低突变负荷和极端分子异质性。尽管其他实体瘤的治疗取得了变革性成功,GBM临床疗效仍有限,原因包括抗原呈递受损、髓系抑制占主导以及血脑屏障(BBB)限制。本综述全面整合GBM免疫治疗格局,涵盖免疫检查点阻断、疫苗、溶瘤病毒治疗和过继细胞疗法。不同于传统按治疗方式分类的综述,我们提出围绕抗肿瘤免疫四个核心支柱组织的整合框架:增强抗原呈递、逆转T细胞功能障碍、重编程抑制性TME,以及实现有效的颅内递送。我们详述机制依据,并重点介绍近期临床突破,包括双特异性T细胞接合剂,以及2024–2025年二价CAR-T 和TEAM-CAR-T 细胞设计的重要进展。通过阐述耐药机制并识别治疗策略的交汇点,我们旨在提出研究重点,使“冷”GBM生态位能够支持持久抗肿瘤免疫。

展开英文摘要原文

Glioblastoma (GBM) remains a recalcitrant primary brain malignancy characterized by a profound immunosuppressive tumor microenvironment (TME), low mutational burden, and extreme molecular heterogeneity. Despite transformative successes in other solid tumors, clinical efficacy in GBM remains modest due to multifaceted barriers, including impaired antigen presentation, dominant myeloid suppression, and the restrictive blood-brain barrier (BBB).

This review provides a comprehensive synthesis of the immunotherapeutic landscape, encompassing checkpoint blockade, vaccines, oncolytic virotherapy, and adoptive cellular therapies. Diverging from traditional modality-centric descriptions, we propose an integrated framework organized around four core pillars of antitumor immunity: enhancing antigen presentation, reversing T cell dysfunction, reprogramming the suppressive TME, and engineering effective intracranial delivery.

We detail mechanistic rationales and prioritize recent clinical breakthroughs, including bispecific T-cell engagers and the 2024-2025 milestones in bivalent and TEAM-CAR T cell designs. By delineating mechanisms of resistance and identifying areas of therapeutic convergence, we aim to outline research priorities to render the "cold" GBM niche permissive to durable antitumor immunity.

论文信息

作者
Abuliezi N、Zhao J、Sun Y、Tuersong T、Dun X、Wu Q
单位
The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.China
文献类型
综述
期刊
Frontiers in medicine2026
原文标识
PubMed 42388505 · DOI 10.3389/fmed.2026.1848364