Immunotherapy for Malignant Gliomas: Overcoming Barriers and Defining Prospects for Integrated Approaches

In recent years significant advancements have been made in immunotherapy and its application in various types of malignancies. However, standard treatment methods for malignant gliomas, including glioblastoma, have not undergone substantial transformations. The main barriers to the application of immunotherapy in these tumors are associated with the specific characteristics of the tumor microenvironment, immunosuppressive status of the central nervous system, protective function of the blood-brain barrier, and challenges in interpreting neuroimaging data. Additionally, gliomas are characterized by low PD-L1 expression, low mutational burden, and high heterogeneity, which limits the effectiveness of immunotherapy. Nevertheless, clinical studies demonstrate promising results with the use of immune checkpoint inhibitors, viral therapies, vaccination, and adoptive T-cell therapy. The integration of immunotherapy with radiation therapy to enhance the immune response obtains high potential for managing oncological issues. Further research in this area, including the development of glioblastoma-specific biomarkers and adaptation of immunotherapy to the characteristics of tumor microenvironment will significantly improve the treatment outcomes for malignant gliomas.