ABSTRACT
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, identifying the cellular basis of clinical vaccine benefits, and
increasing the proportion of patients experiencing such 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, providing a glimpse of the strength to which
immunity influences glioma clinical outcome, and hope that clinically effective vaccines to
treat these tumors are 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.
