Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma

Diffuse midline glioma (DMG) is an incurable malignancy with the highest mortality rate among pediatric brain tumors. While radiotherapy and chemotherapy are the most common treatments, these modalities have limited promise. Due to their diffuse nature in critical areas of the brain, the prognosis o...

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Main Authors: Gabrielle Price, Alexandros Bouras, Dolores Hambardzumyan, Constantinos G. Hadjipanayis
Format: Article
Language:English
Published: Elsevier 2021-07-01
Series:EBioMedicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352396421002462
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author Gabrielle Price
Alexandros Bouras
Dolores Hambardzumyan
Constantinos G. Hadjipanayis
author_facet Gabrielle Price
Alexandros Bouras
Dolores Hambardzumyan
Constantinos G. Hadjipanayis
author_sort Gabrielle Price
collection DOAJ
description Diffuse midline glioma (DMG) is an incurable malignancy with the highest mortality rate among pediatric brain tumors. While radiotherapy and chemotherapy are the most common treatments, these modalities have limited promise. Due to their diffuse nature in critical areas of the brain, the prognosis of DMG remains dismal. DMGs are characterized by unique phenotypic heterogeneity and histological features. Mutations of H3K27M, TP53, and ACVR1 drive DMG tumorigenesis. Histological artifacts include pseudopalisading necrosis and vascular endothelial proliferation. Mouse models that recapitulate human DMG have been used to study key driver mutations and the tumor microenvironment. DMG consists of a largely immunologically cold tumor microenvironment that lacks immune cell infiltration, immunosuppressive factors, and immune surveillance. While tumor-associated macrophages are the most abundant immune cell population, there is reduced T lymphocyte infiltration. Immunotherapies can stimulate the immune system to find, attack, and eliminate cancer cells. However, it is critical to understand the immune microenvironment of DMG before designing immunotherapies since differences in the microenvironment influence treatment efficacy. To this end, our review aims to overview the immune microenvironment of DMG, discuss emerging insights about the immune landscape that drives disease pathophysiology, and present recent findings and new opportunities for therapeutic discovery.
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spelling doaj.art-c02e4e186e02462b86fa643815b87a2b2022-12-21T19:51:41ZengElsevierEBioMedicine2352-39642021-07-0169103453Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline gliomaGabrielle Price0Alexandros Bouras1Dolores Hambardzumyan2Constantinos G. Hadjipanayis3Department of Neurosurgery, Icahn School of Medicine at Mount Sinai,10 Union Square East, 5th Floor, Suite 5E, New York, NY 10003, USA; Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USADepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai,10 Union Square East, 5th Floor, Suite 5E, New York, NY 10003, USA; Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USADepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai,10 Union Square East, 5th Floor, Suite 5E, New York, NY 10003, USA; Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USADepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai,10 Union Square East, 5th Floor, Suite 5E, New York, NY 10003, USA; Department of Oncological Sciences, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Corresponding author at: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai,10 Union Square East, 5th Floor, Suite 5E, New York, NY 10003, USA.Diffuse midline glioma (DMG) is an incurable malignancy with the highest mortality rate among pediatric brain tumors. While radiotherapy and chemotherapy are the most common treatments, these modalities have limited promise. Due to their diffuse nature in critical areas of the brain, the prognosis of DMG remains dismal. DMGs are characterized by unique phenotypic heterogeneity and histological features. Mutations of H3K27M, TP53, and ACVR1 drive DMG tumorigenesis. Histological artifacts include pseudopalisading necrosis and vascular endothelial proliferation. Mouse models that recapitulate human DMG have been used to study key driver mutations and the tumor microenvironment. DMG consists of a largely immunologically cold tumor microenvironment that lacks immune cell infiltration, immunosuppressive factors, and immune surveillance. While tumor-associated macrophages are the most abundant immune cell population, there is reduced T lymphocyte infiltration. Immunotherapies can stimulate the immune system to find, attack, and eliminate cancer cells. However, it is critical to understand the immune microenvironment of DMG before designing immunotherapies since differences in the microenvironment influence treatment efficacy. To this end, our review aims to overview the immune microenvironment of DMG, discuss emerging insights about the immune landscape that drives disease pathophysiology, and present recent findings and new opportunities for therapeutic discovery.http://www.sciencedirect.com/science/article/pii/S2352396421002462Diffuse midline gliomaMicroenvironmentMacrophageMicrogliaImmunotherapyH3K27M
spellingShingle Gabrielle Price
Alexandros Bouras
Dolores Hambardzumyan
Constantinos G. Hadjipanayis
Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
EBioMedicine
Diffuse midline glioma
Microenvironment
Macrophage
Microglia
Immunotherapy
H3K27M
title Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
title_full Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
title_fullStr Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
title_full_unstemmed Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
title_short Current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
title_sort current knowledge on the immune microenvironment and emerging immunotherapies in diffuse midline glioma
topic Diffuse midline glioma
Microenvironment
Macrophage
Microglia
Immunotherapy
H3K27M
url http://www.sciencedirect.com/science/article/pii/S2352396421002462
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AT doloreshambardzumyan currentknowledgeontheimmunemicroenvironmentandemergingimmunotherapiesindiffusemidlineglioma
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