Purpose of review: The present review focuses on recent progress in tumour immunology and immunotherapeutic trials in malignant gliomas.
Recent findings: Major advances have been made in the understanding of antitumour immunity in patients with glioma. Patients with glioblastoma can spontaneously develop antitumour activity with activated CD8+ T cells. Infiltration of myeloid suppressor cells into tumours and increased regulatory T-cell fraction appear to play a critical role in tumour tolerance, however. T-regulatory removal suppresses CD4+ T-cell proliferative defects and can induce tumour rejection in a murine model. Clinical trials using active immunotherapy with dendritic cells loaded with tumour-eluted peptides or tumour lysate have successfully induced antitumour cytotoxicity and some radiologic responses. Other promising approaches targeting the mechanisms of tolerance that could be referred to as 'corrective immunotherapy' are currently on going.
Summary: Improvements in clinical methods and large randomized trials are now needed to prove the usefulness of cancer vaccines. Indeed, comprehensive analysis of tumour immunology and new immunization protocols suggest that immunotherapy can become an efficacious treatment in the near future. Combination with radiotherapy or chemotherapy should be investigated.