The future in glioblastoma treatment

Glioblastoma multiforme (GBM) is the most aggressive tumor that affects humans. Surgical treatment based on cytoreduction presents serious limitations. Consequently, treatments that use selective measures, in order to define relevant antigens that retard growth and recurrences, acquire a prominent position. The complex tumor microenvironment and the infiltration into adjacent tissues make surgical therapies, radiotherapy and chemotherapy, approaches still unsatisfactory when the increase in survival rate is evaluated. Studies on central nervous system immunovigilance have found the presence of lymphatic vessels and the perivascular system that allows the presentation of antigens to T4 cells bringing with it great relevance of immunotherapy, and the creation of active immune responses, recruiting the immune system itself to fight the tumor locally or systemically. Objectives: Determine the effectiveness of combining immunotherapy with conventional therapies of treatments in order to prolong the survival of patients with GBM. Methodology: Databases of Springer Link, Oxford academic, PubMed, Biblioteca USP. Results: For an active immunotherapy to be well-defined, it is necessary to have a strong and efficient antigen presentation breaking the state of tumor immune tolerance and activating effector lymphocytes. The use of dendritic cells for this presentation may be a good strategy. Finally, the antitumor response requires coordination between various local and systemic components. Conclusion: The use of immunotherapy in the treatment of GBM continues to expand. Despite several problems, due to immunosuppression mediated by the tumor itself, the immunotherapy brings a hope regarding to the possibility of to increase the immunogenicity and, thus, prolonging patient survival.