CAR T Cell-Based Immunotherapy for the Treatment of Glioblastoma

Glioblastoma multiforme (GBM) is the most common and aggressive malignant primary brain tumor in adults. Current treatment options typically consist of surgery followed by chemotherapy or more frequently radiotherapy, however, median patient survival remains at just over 1 year. Therefore, the need...

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Bibliographic Details
Published in:	Frontiers in neuroscience Vol. 15; p. 662064
Main Authors:	Maggs, Luke, Cattaneo, Giulia, Dal, Ali Emre, Moghaddam, Ali Sanjari, Ferrone, Soldano
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Research Foundation 25-05-2021 Frontiers Media S.A
Subjects:	Antibodies Antigens Antitumor agents B7 antigen Blood-brain barrier Brain cancer Brain tumors Cancer therapies CAR T cell Central nervous system Chemotherapy Chimeric antigen receptors clinical trial Clinical trials Cytokines Cytotoxicity Epidermal growth factor receptors Glioblastoma Glioblastoma multiforme Immunotherapy Interleukin 1 Lymphocytes Lymphocytes T Medical prognosis Metastases Neuroscience Patients Peptides preclinical Radiation therapy Solid tumors Surgery tumor antigen Tumor microenvironment Vaccines Viruses clinical trial tumor antigen CAR T cell glioblastoma preclinical immunotherapy
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Summary:	Glioblastoma multiforme (GBM) is the most common and aggressive malignant primary brain tumor in adults. Current treatment options typically consist of surgery followed by chemotherapy or more frequently radiotherapy, however, median patient survival remains at just over 1 year. Therefore, the need for novel curative therapies for GBM is vital. Characterization of GBM cells has contributed to identify several molecules as targets for immunotherapy-based treatments such as EGFR/EGFRvIII, IL13Rα2, B7-H3, and CSPG4. Cytotoxic T lymphocytes collected from a patient can be genetically modified to express a chimeric antigen receptor (CAR) specific for an identified tumor antigen (TA). These CAR T cells can then be re-administered to the patient to identify and eliminate cancer cells. The impressive clinical responses to TA-specific CAR T cell-based therapies in patients with hematological malignancies have generated a lot of interest in the application of this strategy with solid tumors including GBM. Several clinical trials are evaluating TA-specific CAR T cells to treat GBM. Unfortunately, the efficacy of CAR T cells against solid tumors has been limited due to several factors. These include the immunosuppressive tumor microenvironment, inadequate trafficking and infiltration of CAR T cells and their lack of persistence and activity. In particular, GBM has specific limitations to overcome including acquired resistance to therapy, limited diffusion across the blood brain barrier and risks of central nervous system toxicity. Here we review current CAR T cell-based approaches for the treatment of GBM and summarize the mechanisms being explored in pre-clinical, as well as clinical studies to improve their anti-tumor activity.
Bibliography:	This article was submitted to Neuropharmacology, a section of the journal Frontiers in Neuroscience Edited by: Elisa Roda, Clinical Scientific Institutes Maugeri (ICS Maugeri), Italy Reviewed by: Hamid Reza Mirzaei, Tehran University of Medical Sciences, Iran; Joachim Steinbach, University Hospital Frankfurt, Germany
ISSN:	1662-4548 1662-453X 1662-453X
DOI:	10.3389/fnins.2021.662064