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Malignant gliomas are the most prevalent type of primary central nervous system (CNS) tumor in adults. Despite progress in brain tumor therapy, the prognosis for malignant glioma patients remains dismal. Standard treatment with temozolomide and radiotherapy for patients with newly diagnosed glioblastoma has increased the median overall survival (OS) by 15–20 months (1), but tumor recurrence is inevitable. Salvage treatments upon recurrence are palliative at best and rarely provide significant survival benefit. Among the new treatments currently being investigated for malignant glioma, immunotherapy is theoretically attractive, because it offers the potential for high tumor-specific cytotoxicity (2). Although recent clinical trials of immunotherapy protocols for malignant gliomas focused on initiating and amplifying a host response with some clinical success, most of them failed to induce objective tumor shrinkage in patients (2). Antitumor activities of tumor cytotoxic T cells (CTL) and antibodies induced by these therapies are insufficient to overcome tumor growth because tumors have immune evasion mechanisms instigated by myeloid derived suppressor cells (MDSCs) and regulatory T cells (Treg) (3). In this paper, we will review past experiences and discuss the promising future of immunotherapeutic approach for glioma treatment.

Experiences and Expectations for Glioma Immunotherapeutic Approaches