Section I. Immunological Features of Brain Tumors
Chapter 1. An Introduction to Immunotherapy in the Treatment of Brain Tumors
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Introduction
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The Immune Response
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Immune Tolerance
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Unique Aspects of the Central Nervous System Immune Response
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Cancer Immunotherapies
Chapter 2. Immune Constitution of Patients With Brain Tumors
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Background and Discovery
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Current Understanding: Analyzing Systemic Immune Dysfunction
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Current Understanding: Analyzing the Tumor
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Clinical Opportunities
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Conclusion
Chapter 3. The Role of Regulatory T Cells and Indoleamine-2,3-dioxygenase in Brain Tumor Immunosuppression
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Background and Discovery
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Origin of Tregs
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Function of Tregs
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Tregs in the Cancer Immunity Cycle
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Tregs and Glioma
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Tryptophan Catabolism in Immunity and in Cancer
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IDO1, IDO2, and TDO
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The AhR
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Mechanisms of Immune Regulation by the IDO Pathway
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The IDO Pathway in Cancer and in Glioma
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Targeting Tregs in Preclinical Model
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Targeting IDO in Preclinical Models
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Clinical Trial Data
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Conclusion
Chapter 4. The Role of Myeloid-Derived Suppressor Cells in Immunosuppression in Brain Tumors
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Background and Discovery of the Myeloid Cell
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Preclinical Data: Targeting the MDSC Population
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Clinical Approaches to Targeting MDSCs
Chapter 5. Tumor-Specific Mutations in Gliomas and Their Implications for Immunotherapy
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Introduction
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Mutations as Immunotherapeutic Targets
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Isocitrate Dehydrogenase 1 Mutations in Gliomas
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IDH1 Mutations as an Immunotherapeutic Target
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Preclinical Investigations: IDH1-R132H Peptide Vaccines
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Clinical Investigations: IDH1-R132H Peptide Vaccines
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Roadblocks and Future Directions for Targeting IDH1 Mutations
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Epidermal Growth Factor Receptor and Variant III in Gliomas
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EGFR Mutations as an Immunotherapeutic Vaccination Target
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Preclinical Investigations: EGFRvIII Vaccination
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Clinical Investigations: EGFRvIII Vaccination
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Roadblocks for Targeting EGFRvIII
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Histone Mutation Background
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Histone Mutations in Pediatric Gliomas
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H3.3 Mutations as an Immunotherapeutic Target
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Roadblocks and Future Directions for Targeting H3 Mutations
Section II. Studying Brain Tumor Immunotherapy
Chapter 6. Preclinical Immunotherapeutic Animal Models for Brain Tumors
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Introduction
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Spontaneous and Experimentally-Induced Autochthonous Brain Tumor Animal Models
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Syngeneic Transplantation Brain Tumor Models
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Genetically Engineered Mouse Models
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Xenograft Models of Glioblastoma
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Humanized Mouse Models
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Conclusion
Chapter 7. Imaging Studies in Immunotherapy
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Clinical Considerations
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Advanced Imaging Assessments
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Conclusion
Chapter 8. Immunotherapy Clinical Trials in Neuro-Oncology
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Introduction
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Early Immunotherapy
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Immunotherapy in the 21st Century
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Checkpoint Inhibitors
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Therapeutic Cancer Vaccines
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Chimeric Antigen Receptor T Cells
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Viral Therapy in Solid Tumors
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Bispecific T Cell Engagers
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Immunotherapy Clinical Trial Design in Neuro-Oncology
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Study Design
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Assessing the Candidate
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Assessment of Safety
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Assessment of Response
Section III. Experimental Brain Tumor Immunotherapies
Chapter 9. Peptide-Specific Vaccines
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Background and Discovery
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Preclinical Data and Principles of Peptide Vaccines
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Clinical Trial Data
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Wilms Tumor Peptide 1
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Vaccination Targeting IDH-1R132H
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Multipeptide Vaccination Regimens
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Conclusion
Chapter 10. Immunotoxin Therapy for Brain Tumors
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Introduction
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History of Immunotoxins
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Immunotoxins for Brain Tumor Therapy
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Future Directions
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Conclusion
Chapter 11. Checkpoint Blockade Immunotherapy for Glioblastoma: Progress and Challenges
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The Tumor Immune Response and Immune Checkpoint Biology
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Immune Checkpoints in Malignant Glioma
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Immune Checkpoint Blockade
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Feasibility of Checkpoint Blockade for Central Nervous System Malignancies
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Clinical Progress of Checkpoint Blockade for Glioblastoma
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Emerging Targets for Checkpoint Blockade
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On the Horizon: Immunomodulatory Antibodies for T Cell Costimulation
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Conclusion
Chapter 12. Dendritic Cell Therapy for Brain Tumors
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Introduction
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Tumor Microenvironment
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Dendritic Cells in Immunology
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Dendritic Cell–Based Vaccine: Current Approaches
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Antigen Targets
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Routes of Administration
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Safety and Complications
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Immune Response
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Clinical Response and Survival Benefits
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Radiologic Findings
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Clinical Trials
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Future Directions
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Conclusion
Chapter 13. Adoptive Immunotherapy Against Brain Tumors
Chapter 14. Chimeric Antigen Receptor Therapy of Brain Tumors
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Chimeric Antigen Receptors Through the Generations
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Success of Targeting Hematogenous Malignancies: CD19 Chimeric Antigen Receptors
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Solid Tumors as a Chimeric Antigen Receptor Target
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Chimeric Antigen Receptor Therapy for Brain Tumors
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The Question of Delivery
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Potential Challenges
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Future Perspectives