Immunotherapy Associated Central Nervous System Complications in Primary Brain Tumors

Overview

Journal Front Oncol

Specialty Oncology

Date 2023 Mar 6

PMID 36874119

Authors

Megan Mantica

Jan Drappatz

Affiliations

Soon will be listed here.

Abstract

Advances clarifying the genetics and function of the immune system within the central nervous system (CNS) and brain tumor microenvironment have led to increasing momentum and number of clinical trials using immunotherapy for primary brain tumors. While neurological complications of immunotherapy in extra-cranial malignancies is well described, the CNS toxicities of immunotherapy in patients with primary brain tumors with their own unique physiology and challenges are burgeoning. This review highlights the emerging and unique CNS complications associated with immunotherapy including checkpoint inhibitors, oncolytic viruses, adoptive cell transfer/chimeric antigen receptor (CAR) T cell and vaccines for primary brain tumors, as well as reviews modalities that have been currently employed or are undergoing investigation for treatment of such toxicities.

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References

Rampling R, Cruickshank G, Papanastassiou V, Nicoll J, Hadley D, Brennan D . Toxicity evaluation of replication-competent herpes simplex virus (ICP 34.5 null mutant 1716) in patients with recurrent malignant glioma. Gene Ther. 2000; 7(10):859-66. DOI: 10.1038/sj.gt.3301184. View

Narita Y, Arakawa Y, Yamasaki F, Nishikawa R, Aoki T, Kanamori M . A randomized, double-blind, phase III trial of personalized peptide vaccination for recurrent glioblastoma. Neuro Oncol. 2018; 21(3):348-359. PMC: 6380422. DOI: 10.1093/neuonc/noy200. View

Cuoco J, Benko M, Busch C, Rogers C, Prickett J, Marvin E . Vaccine-Based Immunotherapeutics for the Treatment of Glioblastoma: Advances, Challenges, and Future Perspectives. World Neurosurg. 2018; 120:302-315. DOI: 10.1016/j.wneu.2018.08.202. View

Chiocca E, Abbed K, Tatter S, Louis D, Hochberg F, Barker F . A phase I open-label, dose-escalation, multi-institutional trial of injection with an E1B-Attenuated adenovirus, ONYX-015, into the peritumoral region of recurrent malignant gliomas, in the adjuvant setting. Mol Ther. 2004; 10(5):958-66. DOI: 10.1016/j.ymthe.2004.07.021. View

Hong M, Clubb J, Chen Y . Engineering CAR-T Cells for Next-Generation Cancer Therapy. Cancer Cell. 2020; 38(4):473-488. DOI: 10.1016/j.ccell.2020.07.005. View

Marelli G, Howells A, Lemoine N, Wang Y . Oncolytic Viral Therapy and the Immune System: A Double-Edged Sword Against Cancer. Front Immunol. 2018; 9:866. PMC: 5932159. DOI: 10.3389/fimmu.2018.00866. View

Bota D, Taylor T, Piccioni D, Duma C, LaRocca R, Kesari S . Phase 2 study of AV-GBM-1 (a tumor-initiating cell targeted dendritic cell vaccine) in newly diagnosed Glioblastoma patients: safety and efficacy assessment. J Exp Clin Cancer Res. 2022; 41(1):344. PMC: 9749349. DOI: 10.1186/s13046-022-02552-6. View

Iwami K, Shimato S, Ohno M, Okada H, Nakahara N, Sato Y . Peptide-pulsed dendritic cell vaccination targeting interleukin-13 receptor α2 chain in recurrent malignant glioma patients with HLA-A*24/A*02 allele. Cytotherapy. 2012; 14(6):733-42. DOI: 10.3109/14653249.2012.666633. View

Yu J, Liu G, Ying H, Yong W, Black K, Wheeler C . Vaccination with tumor lysate-pulsed dendritic cells elicits antigen-specific, cytotoxic T-cells in patients with malignant glioma. Cancer Res. 2004; 64(14):4973-9. DOI: 10.1158/0008-5472.CAN-03-3505. View

10.

Ahmed N, Brawley V, Hegde M, Bielamowicz K, Kalra M, Landi D . HER2-Specific Chimeric Antigen Receptor-Modified Virus-Specific T Cells for Progressive Glioblastoma: A Phase 1 Dose-Escalation Trial. JAMA Oncol. 2017; 3(8):1094-1101. PMC: 5747970. DOI: 10.1001/jamaoncol.2017.0184. View

11.

Ardon H, de Vleeschouwer S, Van Calenbergh F, Claes L, Kramm C, Rutkowski S . Adjuvant dendritic cell-based tumour vaccination for children with malignant brain tumours. Pediatr Blood Cancer. 2009; 54(4):519-25. DOI: 10.1002/pbc.22319. View

12.

Pollack I, Jakacki R, Butterfield L, Hamilton R, Panigrahy A, Potter D . Antigen-specific immune responses and clinical outcome after vaccination with glioma-associated antigen peptides and polyinosinic-polycytidylic acid stabilized by lysine and carboxymethylcellulose in children with newly diagnosed malignant brainstem.... J Clin Oncol. 2014; 32(19):2050-8. PMC: 4067943. DOI: 10.1200/JCO.2013.54.0526. View

13.

Okada H, Weller M, Huang R, Finocchiaro G, Gilbert M, Wick W . Immunotherapy response assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol. 2015; 16(15):e534-e542. PMC: 4638131. DOI: 10.1016/S1470-2045(15)00088-1. View

14.

Markert J, Medlock M, Rabkin S, Gillespie G, Todo T, Hunter W . Conditionally replicating herpes simplex virus mutant, G207 for the treatment of malignant glioma: results of a phase I trial. Gene Ther. 2000; 7(10):867-74. DOI: 10.1038/sj.gt.3301205. View

15.

Batich K, Mitchell D, Healy P, Herndon 2nd J, Sampson J . Once, Twice, Three Times a Finding: Reproducibility of Dendritic Cell Vaccine Trials Targeting Cytomegalovirus in Glioblastoma. Clin Cancer Res. 2020; 26(20):5297-5303. PMC: 9832384. DOI: 10.1158/1078-0432.CCR-20-1082. View

16.

Rubin D, Danish H, Ali A, Li K, LaRose S, Monk A . Neurological toxicities associated with chimeric antigen receptor T-cell therapy. Brain. 2019; 142(5):1334-1348. DOI: 10.1093/brain/awz053. View

17.

Lim M, Xia Y, Bettegowda C, Weller M . Current state of immunotherapy for glioblastoma. Nat Rev Clin Oncol. 2018; 15(7):422-442. DOI: 10.1038/s41571-018-0003-5. View

18.

Akiyama Y, Oshita C, Kume A, Iizuka A, Miyata H, Komiyama M . α-type-1 polarized dendritic cell-based vaccination in recurrent high-grade glioma: a phase I clinical trial. BMC Cancer. 2012; 12:623. PMC: 3541167. DOI: 10.1186/1471-2407-12-623. View

19.

Brown C, Alizadeh D, Starr R, Weng L, Wagner J, Naranjo A . Regression of Glioblastoma after Chimeric Antigen Receptor T-Cell Therapy. N Engl J Med. 2016; 375(26):2561-9. PMC: 5390684. DOI: 10.1056/NEJMoa1610497. View

20.

Pearl T, Markert J, Cassady K, Ghonime M . Oncolytic Virus-Based Cytokine Expression to Improve Immune Activity in Brain and Solid Tumors. Mol Ther Oncolytics. 2019; 13:14-21. PMC: 6453942. DOI: 10.1016/j.omto.2019.03.001. View