Immunotherapies for Central Nervous System Tumors and their Neurologic Complications.

Abstract

Purpose of review: To discuss the landscape of immunotherapy trials for central nervous system (CNS) tumors including immune checkpoint inhibitors, vaccine therapies, oncolytic viruses, and chimeric antigen receptor T-cell therapy as well as explore the corresponding spectrum of neurologic toxicities.

Recent findings: As more clinical trials are underway in CNS tumors, we are starting to appreciate both the promise of immunotherapy and current limitations. While a subset of patients demonstrate benefit, immunotherapy trials have not transformed CNS tumor outcomes, which prompts the field to consider next generation therapies and combinatorial approaches. In addition, novel toxicities of CNS immunotherapy are being described such as tumor-inflammation associated neurotoxicity. Immunotherapy in CNS tumor is still in its nascent stages and shows early signs of promise. However, immunotherapeutic approaches in CNS tumors need to account for the unique physiology of the CNS and the corresponding neurologic toxicities that are associated with therapies targeting the CNS. Elucidating both will set the stage for advancement of safe and effective immunotherapy for CNS tumors.