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07-06-2016 | Glioblastoma multiforme | Book chapter | Article

10. The Immune System and Its Contribution to the Radiotherapeutic Response of Glioblastoma

Authors: Benjamin Cooper, Ralph Vatner, Encouse Golden, Joshua Silverman, Silvia Formenti

Publisher: Springer International Publishing

Abstract

The immune system plays an important role in both counteracting and facilitating cancer development, as well as contributing to the effects of standard cancer treatments. As such, the immune system is most certainly involved in the response of glioblastoma to radiotherapy; however, it is difficult to elucidate the specific role of immunity due to limitations in animal models and the difficulty in obtaining tissue to study molecular correlates of progression and response. Yet there is abundant evidence that leukocytes and other immune mediators recognize and respond to glioma cells, and indirect evidence that they participate in the therapeutic response to radiation. After a brief introduction on the role of the innate and adaptive immune response to cancer, we review the effects of radiotherapy on the anti-tumor immune response, including inflammation, T-cell priming, and immune suppression. We first introduce the concept of radiation induced immunogenic cell death, its application to the unique immunological landscape of the CNS, and present available evidence that radiation induces an immune response against glioblastoma. We then discuss some of the barriers of the brain/tumor microenvironment that may interfere with effective anti-tumor immunity, and conclude with suggested approaches to better harness the immune response in the treatment of glioblastoma with radiotherapy.

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