Future perspectives for immunotherapy of malignant gliomas

Despite advancement in therapeutic regimens, prognosis remains poor for patients with malignant gliomas. As tumors of the central nervous system, gliomas were previously thought to reside in an immunoprivileged area; however evidence is growing that intracranial gliomas finely interact with immune surveillance. Immunotherapeutic approaches have been developed in vitro and in animal models to induce valid antitumoral responses, and several experimental protocols showed their efficacy. Active immunotherapy by dendritic cell vaccination has recently emerged as a particularly promising approach, being able to induce immunological memory and to potentially prevent tumor relapse. Effects on patients survival for dentric cell-based vaccination should be evaluated on vast scale clinical trials to assess methods of preparation and timing for admnistration. Useful synergisms with other immunotherapy approaches have been prospected: T regulatory cell depletion seems at present a particularly attractive tool to disarm tumor immunological resistance.