The dismal prognoses suffered by malignant
primary brain tumor (
glioma) patients remain unchanged over the past two decades despite significant improvements in the treatment of distinct
tumors.
Immunotherapy, and vaccine therapy in particular, represents a promising experimental approach to treat
malignant gliomas, but major challenges still remain to render vaccination clinically effective. These challenges include diminishing the risk of pathologic autoimmunity, and identifying the cellular basis of clinical
vaccine benefits. Addressing such challenges should eventually help increase the proportion of patients experiencing clinical
vaccine benefits. Recent studies in
glioma patients have characterized
tumor antigens on human
gliomas, identified some of the immune cells involved in beneficial anti-
glioma immunity, and examined how
gliomas may be altered by sub-lethal immune influences. This has provided a glimpse of the strength to which immunity influences
glioma clinical outcome, and resurrects hope that clinically effective
vaccines to treat these
tumors is within reach. Insight into the complex dynamics of immune-
tumor interactions promises to extend this reach by delineating mechanisms of immune synergy with other forms of treatment.