surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2024-14-4-351-359surgonco-1021Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSИммунная терапия злокачественных глиом: преодоление барьеров и перспективы комбинированных подходовImmunotherapy for Malignant Gliomas: Overcoming Barriers and Defining Prospects for Integrated Approacheshttps://orcid.org/0000-0002-6149-5460БейлерлиО. А.BeylerliO. A.

Бейлерли Озал Арзуман оглы — к.м.н., старший научный сотрудник

Уфа

Ozal A. Beylerli — Cand. Sci. (Med.), Senior Researcher

Ufa

obeylerli@mail.ruhttps://orcid.org/0000-0002-1241-3019МусаевЭ. Р.MusaevE. R.

Мусаев Эльмар Расим оглы — д.м.н., профессор, член-корр. РАН, кафедра онкологии

Москва

Elmar R. Musaev — Dr. Sci. (Med.), Prof., Corresponding Member of the Russian Academy of Sciences, Department of Oncology

Moscow

https://orcid.org/0000-0002-1488-6290БухвостовА. А.BukhvostovA. A.

Бухвостов Александр Александрович — к.б.н., доцент, кафедра медицинских нанобиотехнологий МБФ

Москва

Alexander A. Bukhvostov — Cand. Sci. (Biol.), Assoc. Prof., Department of Medical Nanobiotechnology, Faculty of Biomedical

Moscow

Центральная научно-исследовательская лаборатория, Башкирский государственный медицинский университетРоссияCentral Research Laboratory, Bashkir State Medical UniversityRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202428122024144351359Copyright © Бейлерли О.А., Мусаев Э.Р., Бухвостов А.А., 20242024Бейлерли О.А., Мусаев Э.Р., Бухвостов А.А.Beylerli O.A., Musaev E.R., Bukhvostov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1021

Несмотря на значительное развитие иммунной терапии (ИТ) в последние годы и ее успешное применение при различных видах злокачественных новообразований, стандартные методы лечения злокачественных глиом, включая глиобластому, не претерпели значительных изменений. Основные препятствия для использования ИТ при этих опухолях связаны с уникальными особенностями микросреды, иммунодепрессивным статусом центральной нервной системы (ЦНС), защитной функцией гематоэнцефалического барьера и трудностями в интерпретации данных нейровизуализации. Кроме того, глиомы характеризуются низкой экспрессией PD-L1, низкой мутационной нагрузкой и высокой гетерогенностью, что ограничивает эффективность ИТ. Несмотря на это, клинические исследования показывают перспективные результаты при использовании ингибиторов контрольных точек иммунитета, вирусной терапии, вакцинации и адаптивной Т-клеточной терапии. Одним из многообещающих направлений является сочетание ИТ с лучевой терапией для усиления иммунного ответа. Дальнейшие исследования в этой области, включая разработку биомаркеров, специфичных для глиобластомы, и адаптацию ИТ к особенностям опухолевой микросреды, могут значительно улучшить исходы лечения злокачественных глиом.

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.

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The authors declare that there are no conflicts of interest present.