[en] Plasticity is a hallmark of aggressive tumors, including glioblastoma (GBM), enabling tumor cells and the tumor microenvironment (TME) to adapt to diverse niches and evade treatment. Here, we discuss how innate and adaptive immune players cooperate in time and space to create an immunosuppressive TME that supports GBM growth and confers resistance to conventional treatments and immunotherapies. We highlight how therapeutic interventions reshape the TME, underscoring the need for targeted approaches to overcome resistance. We introduce the concepts of local TME priming and TME rewiring as necessary foundations for achieving more effective and durable clinical responses in the future.
Precision for document type :
Review article
Disciplines :
Oncology
Author, co-author :
Moreno-Sanchez, Pilar M ✱; NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg ; Faculty of Science, Technology and Medicine (FSTM), University of Luxembourg, Belvaux, Luxembourg
REZAEIPOUR, Mahsa ✱; University of Luxembourg ; NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
Inderberg, Else Marit; Translational Research Unit, Section for Cellular Therapy, Department of Oncology, Oslo University Hospital, Oslo, Norway
Platten, Michael ; Department of Neurology, Medical Faculty Mannheim, Mannheim Center for Translational Neuroscience (MCTN), Heidelberg University, Mannheim, Germany ; CCU Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center, Heidelberg, Germany
GOLEBIEWSKA, Anna ; University of Luxembourg ; NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg. Anna.Golebiewska@lih.lu
✱ These authors have contributed equally to this work.
External co-authors :
yes
Language :
English
Title :
Immunosuppressive mechanisms and therapeutic interventions shaping glioblastoma immunity.
FNR - Fonds National de la Recherche Luxembourg EU Horizon Europe MSCA-DN Televie-FNRS
Funding number :
INTER/TRANSCAN22/17612718/PLASTIG; PRIDE19/14254520/i2TRON; C21/BM/15739125/DIOMEDES; No 101073386 (GLIORESOLVE); n°7.8505.20/7.6603.22
Funding text :
We acknowledge support from the Luxembourg Institute of Health, Televie-FNRS (ImmoGBM no: 7.8505.20/7.6603.22), ERA-NET TRANSCAN-3 PLASTIG (FNR: INTER/TRANSCAN22/17612718/PLASTIG) and the Luxembourg National Research Fund (FNR; PRIDE19/14254520/i2TRON, C21/BM/15739125/DIOMEDES), cofunded by the Fondation Cancer Luxembourg. This project has received funding from the European Union's Horizon Europe research and innovation programme under the Marie Skłodowska-Curie Doctoral Networks grant agreement No 101073386 (GLIORESOLVE) and the ERA PerMed IPerGlio project by the Research Council of Norway.
Louis DN et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary Neuro Oncol. 2021 23 1231 1251 34185076 8328013 10.1093/neuonc/noab106 1:CAS:528:DC%2BB3MXisFSht73J
Stupp R et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma N. Engl. J. Med. 2005 352 987 996 15758009 10.1056/NEJMoa043330 1:CAS:528:DC%2BD2MXit1Wksbk%3D
Ostrom QT et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2016–2020 Neuro Oncol. 2023 25 iv1 iv99 37793125 10550277 10.1093/neuonc/noad149
White K et al. New hints towards a precision medicine strategy for IDH wild-type glioblastoma Ann. Oncol. 2020 31 1679 1692 32918998 10.1016/j.annonc.2020.08.2336 1:STN:280:DC%2BB38bnslyitw%3D%3D
Yabo YA Niclou SP Golebiewska A Cancer cell heterogeneity and plasticity: a paradigm shift in glioblastoma Neuro Oncol. 2022 24 669 682 34932099 10.1093/neuonc/noab269 1:CAS:528:DC%2BB38XjtVahsrvF
Galassi C Chan TA Vitale I Galluzzi L The hallmarks of cancer immune evasion Cancer Cell 2024 42 1825 1863 39393356 10.1016/j.ccell.2024.09.010 1:CAS:528:DC%2BB2cXitF2nsLzI
Galluzzi L Smith KN Liston A Garg AD The diversity of CD8+ T cell dysfunction in cancer and viral infection Nat. Rev. Immunol. 2025 10.1038/s41577-025-01161-6 40216888
Wu B Zhang B Li B Wu H Jiang M Cold and hot tumors: from molecular mechanisms to targeted therapy Signal Transduct. Target. Ther. 2024 9 39420203 11491057 10.1038/s41392-024-01979-x 274
Neftel C et al. An integrative model of cellular states, plasticity, and genetics for glioblastoma Cell 2019 178 835 849 31327527 6703186 10.1016/j.cell.2019.06.024 1:CAS:528:DC%2BC1MXhsVWlur7I
Wang L et al. A single-cell atlas of glioblastoma evolution under therapy reveals cell-intrinsic and cell-extrinsic therapeutic targets Nat. Cancer 2022 3 1534 1552 36539501 9767870 10.1038/s43018-022-00475-x 1:CAS:528:DC%2BB38XjtF2gs7bL
Patel AP et al. Single-cell RNA-seq highlights intratumoral heterogeneity in primary glioblastoma Science 2014 344 1396 1401 24925914 4123637 10.1126/science.1254257 1:CAS:528:DC%2BC2cXpslygsL4%3D
Dirkse A et al. Stem cell-associated heterogeneity in glioblastoma results from intrinsic tumor plasticity shaped by the microenvironment Nat. Commun. 2019 10 30992437 6467886 10.1038/s41467-019-09853-z 1787
Wang Q et al. Tumor evolution of glioma-intrinsic gene expression subtypes associates with immunological changes in the microenvironment Cancer Cell 2017 32 42 56 28697342 5599156 10.1016/j.ccell.2017.06.003
Greenwald AC et al. Integrative spatial analysis reveals a multi-layered organization of glioblastoma Cell 2024 187 2485 2501 38653236 11088502 10.1016/j.cell.2024.03.029 1:CAS:528:DC%2BB2cXovVSrsLY%3D
Nomura M et al. The multilayered transcriptional architecture of glioblastoma ecosystems Nat. Genet. 2025 57 1155 1167 40346361 12081307 10.1038/s41588-025-02167-5 1:CAS:528:DC%2BB2MXhtFersrzF
Faust Akl C et al. Glioblastoma-instructed astrocytes suppress tumour-specific T cell immunity Nature 2025 643 219 229 40399681 10.1038/s41586-025-08997-x 1:CAS:528:DC%2BB2MXhsFCgsb7P
Wälchli T et al. Single-cell atlas of the human brain vasculature across development, adulthood and disease Nature 2024 632 603 613 38987604 11324530 10.1038/s41586-024-07493-y
Khan F et al. Macrophages and microglia in glioblastoma: heterogeneity, plasticity, and therapy J. Clin. Invest. 2023 10.1172/JCI163446 38032740 10721159
Sharma P Aaroe A Liang J Puduvalli VK Tumor microenvironment in glioblastoma: current and emerging concepts Neurooncol. Adv. 2023 5 36968288 10034917 vdad009
Bikfalvi A et al. Challenges in glioblastoma research: focus on the tumor microenvironment Trends Cancer 2023 9 9 27 36400694 10.1016/j.trecan.2022.09.005 1:CAS:528:DC%2BB38XivFajtb%2FN erratum 9, 692 (2023).
Habashy KJ Mansour R Moussalem C Sawaya R Massaad MJ Challenges in glioblastoma immunotherapy: mechanisms of resistance and therapeutic approaches to overcome them Br. J. Cancer 2022 127 976 987 35662275 9470562 10.1038/s41416-022-01864-w
Arrieta VA et al. Immune checkpoint blockade in glioblastoma: from tumor heterogeneity to personalized treatment J. Clin. Invest. 2023 10.1172/JCI163447 37847564 10721147
Bunse L Bunse T Kilian M Quintana FJ Platten M The immunology of brain tumors Sci. Immunol. 2025 10 41042911 10.1126/sciimmunol.ads0449 1:CAS:528:DC%2BB2MXislCqsLbM eads0449
Mahdi J Trivedi V Monje M The promise of immunotherapy for central nervous system tumours Nat. Rev. Immunol. 2025 10.1038/s41577-025-01227-5 41053233
Hambardzumyan D Bergers G Glioblastoma: defining tumor niches Trends Cancer 2015 1 252 265 27088132 4831073 10.1016/j.trecan.2015.10.009
Dermitzakis I et al. CNS border-associated macrophages: ontogeny and potential implication in disease Curr. Issues Mol. Biol. 2023 45 4285 4300 37232741 10217436 10.3390/cimb45050272 1:CAS:528:DC%2BB3sXhtFCqsLjM
Mrdjen D et al. High-dimensional single-cell mapping of central nervous system immune cells reveals distinct myeloid subsets in health, aging, and disease Immunity 2018 48 380 395 29426702 10.1016/j.immuni.2018.01.011 1:CAS:528:DC%2BC1cXit12qs70%3D
Friebel E et al. Single-cell mapping of human brain cancer reveals tumor-specific instruction of tissue-invading leukocytes Cell 2020 181 1626 1642 32470397 10.1016/j.cell.2020.04.055 1:CAS:528:DC%2BB3cXhtVKntb7F
Pombo Antunes AR et al. Single-cell profiling of myeloid cells in glioblastoma across species and disease stage reveals macrophage competition and specialization Nat. Neurosci. 2021 24 595 610 33782623 10.1038/s41593-020-00789-y 1:CAS:528:DC%2BB3MXns1Ontbg%3D
Ochocka N et al. Single-cell RNA sequencing reveals functional heterogeneity of glioma-associated brain macrophages Nat. Commun. 2021 12 33608526 7895824 10.1038/s41467-021-21407-w 1:CAS:528:DC%2BB3MXltFyju7g%3D 1151
Yabo YA et al. Glioblastoma-instructed microglia transition to heterogeneous phenotypic states with phagocytic and dendritic cell-like features in patient tumors and patient-derived orthotopic xenografts Genome Med. 2024 16 38566128 10988817 10.1186/s13073-024-01321-8 1:CAS:528:DC%2BB2cXnsVKlsrc%3D 51
Klemm F et al. Interrogation of the microenvironmental landscape in brain tumors reveals disease-specific alterations of immune cells Cell 2020 181 1643 1660 32470396 8558904 10.1016/j.cell.2020.05.007 1:CAS:528:DC%2BB3cXhtVKntLfE
Miller TE et al. Programs, origins and immunomodulatory functions of myeloid cells in glioma Nature 2025 10.1038/s41586-025-08633-8 41315740 12711578
González-Tablas Pimenta M et al. Tumor cell and immune cell profiles in primary human glioblastoma: impact on patient outcome Brain Pathol. 2021 31 365 380 33314398 8018082 10.1111/bpa.12927
Bayik D et al. Myeloid-derived suppressor cell subsets drive glioblastoma growth in a sex-specific manner Cancer Discov. 2020 10 1210 1225 32300059 7415660 10.1158/2159-8290.CD-19-1355 1:CAS:528:DC%2BB3cXit1ehsLbP
Jackson C et al. Distinct myeloid-derived suppressor cell populations in human glioblastoma Science 2025 387 39818911 10.1126/science.abm5214 1:CAS:528:DC%2BB2MXhvVehsbc%3D eabm5214
Zhao J et al. Disease-specific suppressive granulocytes participate in glioma progression Cell Rep. 2024 43 39630582 10.1016/j.celrep.2024.115014 1:CAS:528:DC%2BB2cXis1Ggsr3N 115014
Maas RR et al. The local microenvironment drives activation of neutrophils in human brain tumors Cell 2023 186 4546 4566 37769657 10.1016/j.cell.2023.08.043 1:CAS:528:DC%2BB3sXitVSqtrnO
Yang Y et al. Large-scale bulk and single-cell RNA sequencing combined with machine learning reveals glioblastoma-associated neutrophil heterogeneity and establishes a VEGFA+ neutrophil prognostic model Biol. Direct 2025 20 40188324 11972500 10.1186/s13062-025-00640-z 1:CAS:528:DC%2BB2MXot12hsb4%3D 45
Chen Z et al. Monocyte depletion enhances neutrophil influx and proneural to mesenchymal transition in glioblastoma Nat. Commun. 2023 14 37012245 10070461 10.1038/s41467-023-37361-8 1:CAS:528:DC%2BB3sXntVejsbk%3D 1839
Chanoch-Myers R Wider A Suva ML Tirosh I Elucidating the diversity of malignant mesenchymal states in glioblastoma by integrative analysis Genome Med. 2022 14 36123598 9484143 10.1186/s13073-022-01109-8 1:CAS:528:DC%2BB38XisV2gtLfP 106
Rashidi A et al. Myeloid cell-derived creatine in the hypoxic niche promotes glioblastoma growth Cell Metab. 2024 36 62 77 38134929 10.1016/j.cmet.2023.11.013 1:CAS:528:DC%2BB3sXis1Oqu7fJ
Mitsdoerffer M et al. The glioblastoma multiforme tumor site promotes the commitment of tumor-infiltrating lymphocytes to the TH17 lineage in humans Proc. Natl Acad. Sci. USA 2022 119 35969754 9407554 10.1073/pnas.2206208119 1:CAS:528:DC%2BB38XisVChsrvL e2206208119
Andaloussi AE Lesniak MS An increase in CD4+CD25+FOXP3+ regulatory T cells in tumor-infiltrating lymphocytes of human glioblastoma multiforme Neuro Oncol. 2006 8 234 243 16723631 1871953 10.1215/15228517-2006-006
Mohme M et al. Immunophenotyping of newly diagnosed and recurrent glioblastoma defines distinct immune exhaustion profiles in peripheral and tumor-infiltrating lymphocytes Clin. Cancer Res. 2018 24 4187 4200 29444930 10.1158/1078-0432.CCR-17-2617 1:CAS:528:DC%2BC1MXjtVahs7w%3D
van Hooren L et al. Agonistic CD40 therapy induces tertiary lymphoid structures but impairs responses to checkpoint blockade in glioma Nat. Commun. 2021 12 34226552 8257767 10.1038/s41467-021-24347-7 4127
Cakmak P et al. Spatial immune profiling defines a subset of human gliomas with functional tertiary lymphoid structures Immunity 2025 58 2025 2863.e2848 10.1016/j.immuni.2025.09.018
Wang F et al. Comparison of tumor immune environment between newly diagnosed and recurrent glioblastoma including matched patients J. Neurooncol. 2022 159 163 175 35754074 10.1007/s11060-022-04053-0 1:CAS:528:DC%2BB38XitFOmurbI
Breznik B et al. Infiltrating natural killer cells bind, lyse and increase chemotherapy efficacy in glioblastoma stem-like tumorospheres Commun. Biol. 2022 5 35538218 9090761 10.1038/s42003-022-03402-z 1:CAS:528:DC%2BB38XhvVGns73M 436
Kmiecik J et al. Elevated CD3+ and CD8+ tumor-infiltrating immune cells correlate with prolonged survival in glioblastoma patients despite integrated immunosuppressive mechanisms in the tumor microenvironment and at the systemic level J. Neuroimmunol. 2013 264 71 83 24045166 10.1016/j.jneuroim.2013.08.013 1:CAS:528:DC%2BC3sXhsVClsLfO
Hou D et al. Antigen-presenting B cells promote TCF-1+ PD1− stem-like CD8+ T-cell proliferation in glioblastoma Front. Immunol. 2024 14 38268923 10806106 10.3389/fimmu.2023.1295218 1295218
Gao J et al. Infiltrating plasma cells maintain glioblastoma stem cells through IgG–tumor binding Cancer Cell 2024 10.1016/j.ccell.2024.12.006 39672166 11560503
Woroniecka K et al. T-cell exhaustion signatures vary with tumor type and are severe in glioblastoma Clin. Cancer Res. 2018 24 4175 4186 29437767 6081269 10.1158/1078-0432.CCR-17-1846 1:CAS:528:DC%2BC1MXjtVaiu7k%3D
Chongsathidkiet P et al. Sequestration of T cells in bone marrow in the setting of glioblastoma and other intracranial tumors Nat. Med. 2018 24 1459 1468 30104766 6129206 10.1038/s41591-018-0135-2 1:CAS:528:DC%2BC1cXhsFSqtb%2FI
Magri S et al. Sustained accumulation of blood-derived macrophages in the immune microenvironment of patients with recurrent glioblastoma after therapy Cancers (Basel) 2021 13 34944798 10.3390/cancers13246178 1:CAS:528:DC%2BB38XkvFKgt7o%3D 6178
Pires-Afonso Y et al. Elucidating tumour-associated microglia/macrophage diversity along glioblastoma progression and under ACOD1 deficiency Mol. Oncol. 2022 16 3167 3191 35838338 9441003 10.1002/1878-0261.13287 1:CAS:528:DC%2BB38XisVeqtb%2FL
Kirschenbaum D et al. Time-resolved single-cell transcriptomics defines immune trajectories in glioblastoma Cell 2024 187 149 165 38134933 10.1016/j.cell.2023.11.032 1:CAS:528:DC%2BB3sXis1Oqu7nF
Sattiraju A et al. Hypoxic niches attract and sequester tumor-associated macrophages and cytotoxic T cells and reprogram them for immunosuppression Immunity 2023 56 1825 1843 37451265 10527169 10.1016/j.immuni.2023.06.017 1:CAS:528:DC%2BB3sXhsVKmtL%2FN
Lohr J et al. Effector T-cell infiltration positively impacts survival of glioblastoma patients and is impaired by tumor-derived TGF-β Clin. Cancer Res. 2011 17 4296 4308 21478334 10.1158/1078-0432.CCR-10-2557 1:CAS:528:DC%2BC3MXos1Smt7w%3D
Dobersalske C et al. Cranioencephalic functional lymphoid units in glioblastoma Nat. Med. 2024 30 2947 2956 39085419 11485206 10.1038/s41591-024-03152-x 1:CAS:528:DC%2BB2cXhs1Oht7fP
Koh BI et al. Adult skull bone marrow is an expanding and resilient haematopoietic reservoir Nature 2024 636 172 181 39537918 11618084 10.1038/s41586-024-08163-9 1:CAS:528:DC%2BB2cXisV2nur3K
Du L et al. Both IDO1 and TDO contribute to the malignancy of gliomas via the Kyn–AhR–AQP4 signaling pathway Signal Transduct. Target. Ther. 2020 5 32296044 7033114 10.1038/s41392-019-0103-4 1:CAS:528:DC%2BB3cXksVWhtbg%3D 10
Takenaka MC et al. Control of tumor-associated macrophages and T cells in glioblastoma via AHR and CD39 Nat. Neurosci. 2019 22 729 740 30962630 8052632 10.1038/s41593-019-0370-y 1:CAS:528:DC%2BC1MXosVShurc%3D
Didenko VV Ngo HN Minchew C Baskin DS Apoptosis of T lymphocytes invading glioblastomas multiforme: a possible tumor defense mechanism J. Neurosurg. 2002 96 580 584 11883844 1853267 10.3171/jns.2002.96.3.0580 1:CAS:528:DC%2BD38Xit1ymtL8%3D
Badie B Schartner J Prabakaran S Paul J Vorpahl J Expression of Fas ligand by microglia: possible role in glioma immune evasion J. Neuroimmunol. 2001 120 19 24 11694315 10.1016/S0165-5728(01)00361-7 1:CAS:528:DC%2BD3MXnvFKjtr8%3D
Butt NS et al. Major histocompatibility class-I (MHC-I) downregulation in glioblastoma is a poor prognostic factor but not a predictive indicator for treatment failure Pathol. Res. Pract. 2023 250 37725880 10.1016/j.prp.2023.154816 1:CAS:528:DC%2BB3sXhvFCgsb3L 154816
Yang W Li Y Gao R Xiu Z Sun T MHC class I dysfunction of glioma stem cells escapes from CTL-mediated immune response via activation of Wnt/β-catenin signaling pathway Oncogene 2020 39 1098 1111 31591480 10.1038/s41388-019-1045-6 1:CAS:528:DC%2BC1MXhvFWkurfP
Zhang M et al. Anti-CD47 treatment stimulates phagocytosis of glioblastoma by M1 and M2 polarized macrophages and promotes M1 polarized macrophages in vivo PLoS ONE 2016 11 27092773 4836698 10.1371/journal.pone.0153550 e0153550
Wu M et al. Phagocytosis of glioma cells enhances the immunosuppressive phenotype of bone marrow-derived macrophages Cancer Res. 2023 83 771 785 36622331 9978884 10.1158/0008-5472.CAN-22-1570 1:CAS:528:DC%2BB3sXnt1ygu7c%3D
Schmassmann P et al. Targeting the Siglec–sialic acid axis promotes antitumor immune responses in preclinical models of glioblastoma Sci. Transl. Med. 2023 15 37467314 10.1126/scitranslmed.adf5302 1:CAS:528:DC%2BB3sXhsV2lsbfO eadf5302
von Roemeling CA et al. Therapeutic modulation of phagocytosis in glioblastoma can activate both innate and adaptive antitumour immunity Nat. Commun. 2020 11 10.1038/s41467-020-15129-8 1508
Mei Y et al. Siglec-9 acts as an immune-checkpoint molecule on macrophages in glioblastoma, restricting T-cell priming and immunotherapy response Nat. Cancer 2023 4 1273 1291 37460871 10.1038/s43018-023-00598-9 1:CAS:528:DC%2BB3sXhsFaitrfO
Gordon SR et al. PD-1 expression by tumour-associated macrophages inhibits phagocytosis and tumour immunity Nature 2017 545 495 499 28514441 5931375 10.1038/nature22396 1:CAS:528:DC%2BC2sXnvVCrs70%3D
Jadus MR et al. Macrophages kill T9 glioma tumor cells bearing the membrane isoform of macrophage colony stimulating factor through a phagocytosis-dependent pathway J. Immunol. 1998 160 361 368 9551992 10.4049/jimmunol.160.1.361 1:CAS:528:DyaK1cXhtFWmuw%3D%3D
Afzal A et al. Phagocytosis checkpoints in glioblastoma: CD47 and beyond Curr. Issues Mol. Biol. 2024 46 7795 7811 39194679 11352848 10.3390/cimb46080462 1:CAS:528:DC%2BB2cXitFOjsbjF
Kopatz J et al. Siglec-h on activated microglia for recognition and engulfment of glioma cells Glia 2013 61 1122 1133 23633299 10.1002/glia.22501
Kim H-J et al. Blood monocyte-derived CD169+ macrophages contribute to antitumor immunity against glioblastoma Nat. Commun. 2022 13 36266311 9585054 10.1038/s41467-022-34001-5 1:CAS:528:DC%2BB38XislWitbbK 6211
Saavedra-López E et al. Phagocytic glioblastoma-associated microglia and macrophages populate invading pseudopalisades Brain Commun. 2020 2 32954312 10.1093/braincomms/fcz043 fcz043
Friedrich M et al. Dysfunctional dendritic cells limit antigen-specific T cell response in glioma Neuro Oncol. 2023 25 263 276 35609569 10.1093/neuonc/noac138 1:CAS:528:DC%2BB3sXhsFKiu7zP
Carenza C et al. Perioperative corticosteroid treatment impairs tumor-infiltrating dendritic cells in patients with newly diagnosed adult-type diffuse gliomas Front. Immunol. 2022 13 36703985 10.3389/fimmu.2022.1074762 1:CAS:528:DC%2BB3sXislartrk%3D 1074762
Chang AL et al. CCL2 produced by the glioma microenvironment is essential for the recruitment of regulatory T cells and myeloid-derived suppressor cells Cancer Res. 2016 76 5671 5682 27530322 5050119 10.1158/0008-5472.CAN-16-0144 1:CAS:528:DC%2BC28Xhs1SmtL3I
Guan X et al. CTLA4-mediated immunosuppression in glioblastoma is associated with the infiltration of macrophages in the tumor microenvironment J. Inflamm. Res. 2021 14 7315 7329 34992419 8712744 10.2147/JIR.S341981 1:CAS:528:DC%2BB38Xps12kurs%3D
Abdelfattah N et al. Single-cell analysis of human glioma and immune cells identifies S100A4 as an immunotherapy target Nat. Commun. 2022 13 35140215 8828877 10.1038/s41467-022-28372-y 1:CAS:528:DC%2BB38Xjt1Cmu7g%3D 767
Lerner EC et al. CD8+ T cells maintain killing of MHC-I-negative tumor cells through the NKG2D–NKG2DL axis Nat. Cancer 2023 4 1258 1272 37537301 10518253 10.1038/s43018-023-00600-4 1:CAS:528:DC%2BB3sXhslShs7vN
Hu X et al. Meningeal lymphatic vessels regulate brain tumor drainage and immunity Cell Res. 2020 30 229 243 32094452 7054407 10.1038/s41422-020-0287-8 1:CAS:528:DC%2BB3cXkt1ehu7Y%3D
Song E et al. VEGF-C-driven lymphatic drainage enables immunosurveillance of brain tumours Nature 2020 577 689 694 31942068 7100608 10.1038/s41586-019-1912-x 1:CAS:528:DC%2BB3cXis1Sitro%3D
Blobner J et al. Comparative evaluation of T-cell receptors in experimental glioma-draining lymph nodes Neurooncol. Adv. 2021 3 34738084 8562732 vdab147
Ravi VM et al. T-cell dysfunction in the glioblastoma microenvironment is mediated by myeloid cells releasing interleukin-10 Nat. Commun. 2022 13 35177622 8854421 10.1038/s41467-022-28523-1 1:CAS:528:DC%2BB38XktVOhsLw%3D 925
Miller BC et al. Subsets of exhausted CD8+ T cells differentially mediate tumor control and respond to checkpoint blockade Nat. Immunol. 2019 20 326 336 30778252 6673650 10.1038/s41590-019-0312-6 1:CAS:528:DC%2BC1MXnsVCitbg%3D
Polania JW et al. Antigen presentation by tumor-associated macrophages drives T cells from a progenitor exhaustion state to terminal exhaustion Immunity 2024 10.1016/j.immuni.2024.11.026
Kilian M et al. MHC class II-restricted antigen presentation is required to prevent dysfunction of cytotoxic T cells by blood-borne myeloids in brain tumors Cancer Cell 2023 41 235 251 36638785 10.1016/j.ccell.2022.12.007 1:CAS:528:DC%2BB3sXhtVGnsb8%3D
Vijayanathan Y Ho IAW The impact of metabolic rewiring in glioblastoma: the immune landscape and therapeutic strategies Int. J. Mol. Sci. 2025 26 39859381 11765942 10.3390/ijms26020669 1:CAS:528:DC%2BB2MXislyitrw%3D 669
De Leo A et al. Glucose-driven histone lactylation promotes the immunosuppressive activity of monocyte-derived macrophages in glioblastoma Immunity 2024 57 1105 1123 38703775 11114377 10.1016/j.immuni.2024.04.006
Wang S et al. Oncolytic viruses engineered to enforce cholesterol efflux restore tumor-associated macrophage phagocytosis and anti-tumor immunity in glioblastoma Nat. Commun. 2023 14 37474548 10359270 10.1038/s41467-023-39683-z 1:CAS:528:DC%2BB3sXhsFejtrnM 4367
Governa V et al. Protumoral lipid droplet-loaded macrophages are enriched in human glioblastoma and can be therapeutically targeted Sci. Transl. Med. 2024 16 39475570 10.1126/scitranslmed.adk1168 1:CAS:528:DC%2BB2cXisVOis7jN eadk1168
Kloosterman DJ et al. Macrophage-mediated myelin recycling fuels brain cancer malignancy Cell 2024 187 5336 5356 39137777 11429458 10.1016/j.cell.2024.07.030 1:CAS:528:DC%2BB2cXhslCjtbvF
Huff WX et al. Aging- and tumor-mediated increase in CD8+CD28− T cells might impose a strong barrier to success of immunotherapy in glioblastoma Immunohorizons 2021 5 395 409 34103370 10.4049/immunohorizons.2100008 1:CAS:528:DC%2BB3MXhslWgt7rK
Scharping NE et al. Mitochondrial stress induced by continuous stimulation under hypoxia rapidly drives T cell exhaustion Nat. Immunol. 2021 22 205 215 33398183 7971090 10.1038/s41590-020-00834-9 1:CAS:528:DC%2BB3MXjt1SitQ%3D%3D
Lin AJ et al. Impact of concurrent versus adjuvant chemotherapy on the severity and duration of lymphopenia in glioma patients treated with radiation therapy J. Neurooncol. 2018 136 403 411 29143923 10.1007/s11060-017-2668-5
Karachi A et al. Modulation of temozolomide dose differentially affects T-cell response to immune checkpoint inhibition Neuro Oncol. 2019 21 730 741 30668768 6556847 10.1093/neuonc/noz015 1:CAS:528:DC%2BB3cXht1agurnM
Varn FS et al. Glioma progression is shaped by genetic evolution and microenvironment interactions Cell 2022 185 2184 2199 35649412 9189056 10.1016/j.cell.2022.04.038 1:CAS:528:DC%2BB38XhsVWjt7fE
Spitzer A et al. Deciphering the longitudinal trajectories of glioblastoma ecosystems by integrative single-cell genomics Nat. Genet. 2025 57 1168 1178 40346362 12081298 10.1038/s41588-025-02168-4 1:CAS:528:DC%2BB2MXhtFersrzI
Loussouarn D et al. Spatial distribution of immune cells in primary and recurrent glioblastoma: a small case study Cancers (Basel) 2023 15 37370866 10.3390/cancers15123256 1:CAS:528:DC%2BB3sXhsVagsLbE 3256
Shekarian T et al. Multidimensional analysis of matched primary and recurrent glioblastoma identifies contributors to tumor recurrence influencing time to relapse J. Neuropathol. Exp. Neurol. 2024 84 45 58 11659594 10.1093/jnen/nlae108
Onubogu U et al. Spatial analysis of recurrent glioblastoma reveals perivascular niche organization JCI Insight 2024 10.1172/jci.insight.179853 38805346 11383164
van Hooren L et al. CD103+ regulatory T cells underlie resistance to radio-immunotherapy and impair CD8+ T cell activation in glioblastoma Nat. Cancer 2023 4 665 681 37081259 10212765 10.1038/s43018-023-00547-6
Tamura R et al. Alterations of the tumor microenvironment in glioblastoma following radiation and temozolomide with or without bevacizumab Ann. Transl. Med. 2020 8 32355741 7186631 10.21037/atm.2020.03.11 297
Wang W et al. Glioblastoma pseudoprogression and true progression reveal spatially variable transcriptional differences Acta Neuropathol. Commun. 2023 11 38049893 10694987 10.1186/s40478-023-01587-w 1:CAS:528:DC%2BB3sXisFGhtLbE 192
Knudsen AM et al. Characterisation of the tumour microenvironment in primary and recurrent glioblastomas Neuropathol. Appl. Neurobiol. 2024 50 39449228 10.1111/nan.13012 1:CAS:528:DC%2BB2cXitlantLfJ e13012
Touat M et al. Mechanisms and therapeutic implications of hypermutation in gliomas Nature 2020 580 517 523 32322066 8235024 10.1038/s41586-020-2209-9 1:CAS:528:DC%2BB3cXntFOltbY%3D
Gromeier M et al. Very low mutation burden is a feature of inflamed recurrent glioblastomas responsive to cancer immunotherapy Nat. Commun. 2021 12 33441554 7806846 10.1038/s41467-020-20469-6 1:CAS:528:DC%2BB3MXhsVCjsLc%3D 352
Akkari L et al. Dynamic changes in glioma macrophage populations after radiotherapy reveal CSF-1R inhibition as a strategy to overcome resistance Sci. Transl. Med. 2020 12 32669424 10.1126/scitranslmed.aaw7843 1:CAS:528:DC%2BB3cXhsVCmur%2FF eaaw7843
Watson SS et al. Fibrotic response to anti-CSF-1R therapy potentiates glioblastoma recurrence Cancer Cell 2024 42 1507 1527 39255775 10.1016/j.ccell.2024.08.012 1:CAS:528:DC%2BB2cXhvFCrsLnJ
Watson SS et al. Microenvironmental reorganization in brain tumors following radiotherapy and recurrence revealed by hyperplexed immunofluorescence imaging Nat. Commun. 2024 15 38622132 11018859 10.1038/s41467-024-47185-9 1:CAS:528:DC%2BB2cXpt12ltb8%3D 3226
Ha W et al. Ibudilast sensitizes glioblastoma to temozolomide by targeting macrophage migration inhibitory factor (MIF) Sci. Rep. 2019 9 30814573 6393433 10.1038/s41598-019-39427-4 2905
Sørensen MD et al. Microglia induce an interferon-stimulated gene expression profile in glioblastoma and increase glioblastoma resistance to temozolomide Neuropathol. Appl. Neurobiol. 2024 50 39558550 11618491 10.1111/nan.13016 e13016
Yeo AT et al. Single-cell RNA sequencing reveals evolution of immune landscape during glioblastoma progression Nat. Immunol. 2022 23 971 984 35624211 9174057 10.1038/s41590-022-01215-0 1:CAS:528:DC%2BB38Xhtl2jsLjF
Tamura R et al. Persistent restoration to the immunosupportive tumor microenvironment in glioblastoma by bevacizumab Cancer Sci. 2019 110 499 508 30467920 10.1111/cas.13889 1:CAS:528:DC%2BC1cXisFKqsr%2FP
Wei Q et al. TNFα secreted by glioma associated macrophages promotes endothelial activation and resistance against anti-angiogenic therapy Acta Neuropathol. Commun. 2021 9 33853689 8048292 10.1186/s40478-021-01163-0 1:CAS:528:DC%2BB3MXht1Smsb7E 67
Aslan K et al. Heterogeneity of response to immune checkpoint blockade in hypermutated experimental gliomas Nat. Commun. 2020 11 32071302 7028933 10.1038/s41467-020-14642-0 1:CAS:528:DC%2BB3cXkvFajurg%3D 931
Lee-Chang C et al. Myeloid-derived suppressive cells promote B cell-mediated immunosuppression via transfer of PD-L1 in glioblastoma Cancer Immunol. Res. 2019 7 1928 1943 31530559 6891201 10.1158/2326-6066.CIR-19-0240 1:CAS:528:DC%2BB3cXht1Ggs7jM
Chryplewicz A et al. Cancer cell autophagy, reprogrammed macrophages, and remodeled vasculature in glioblastoma triggers tumor immunity Cancer Cell 2022 40 1111 1127 36113478 9580613 10.1016/j.ccell.2022.08.014 1:CAS:528:DC%2BB38XisVShtL3F
Klein E Hau A-C Oudin A Golebiewska A Niclou SP Glioblastoma organoids: pre-clinical applications and challenges in the context of immunotherapy Front. Oncol. 2020 10 33364198 7753120 10.3389/fonc.2020.604121 604121
Steindl A Valiente M Potential of ex vivo organotypic slice cultures in neuro-oncology Neuro Oncol. 2025 27 338 351 39504579 10.1093/neuonc/noae195
Wang G Wang W Advanced cell therapies for glioblastoma Front. Immunol. 2022 10.3389/fimmu.2022.904133 36936474 9835811
Choi BD Maus MV June CH Sampson JH Immunotherapy for glioblastoma: adoptive T-cell strategies Clin. Cancer Res. 2019 25 2042 2048 30446589 10.1158/1078-0432.CCR-18-1625 1:CAS:528:DC%2BB3cXhsVeltbfL
Bagley SJ Desai AS Linette GP June CH O’Rourke DM CAR T-cell therapy for glioblastoma: recent clinical advances and future challenges Neuro Oncol. 2018 20 1429 1438 29509936 6176794 10.1093/neuonc/noy032 1:CAS:528:DC%2BC1MXhtlKisb%2FI
Khan SM et al. Impact of CD4 T cells on intratumoral CD8 T-cell exhaustion and responsiveness to PD-1 blockade therapy in mouse brain tumors J. Immunother. Cancer 2022 10.1136/jitc-2022-005293 36543376 9772691
Reardon DA et al. Effect of nivolumab vs bevacizumab in patients with recurrent glioblastoma: the CheckMate 143 phase 3 randomized clinical trial JAMA Oncol. 2020 6 1003 1010 32437507 10.1001/jamaoncol.2020.1024
Lim M et al. Phase III trial of chemoradiotherapy with temozolomide plus nivolumab or placebo for newly diagnosed glioblastoma with methylated MGMT promoter Neuro Oncol. 2022 24 1935 1949 35511454 9629431 10.1093/neuonc/noac116 1:CAS:528:DC%2BB3sXptFaqu7o%3D
Duerinck J et al. Intracerebral administration of CTLA-4 and PD-1 immune checkpoint blocking monoclonal antibodies in patients with recurrent glioblastoma: a phase I clinical trial J. Immunother. Cancer 2021 9 34168003 8231061 10.1136/jitc-2020-002296 e002296
Omuro A et al. Radiotherapy combined with nivolumab or temozolomide for newly diagnosed glioblastoma with unmethylated MGMT promoter: an international randomized phase III trial Neuro Oncol. 2023 25 123 134 35419607 10.1093/neuonc/noac099 1:CAS:528:DC%2BB3sXhsVyhsrrE
Lee AH et al. Neoadjuvant PD-1 blockade induces T cell and cDC1 activation but fails to overcome the immunosuppressive tumor associated macrophages in recurrent glioblastoma Nat. Commun. 2021 12 34836966 8626557 10.1038/s41467-021-26940-2 1:CAS:528:DC%2BB3MXisFyrtLnF 6938
Schalper KA et al. Neoadjuvant nivolumab modifies the tumor immune microenvironment in resectable glioblastoma Nat. Med. 2019 25 470 476 30742120 10.1038/s41591-018-0339-5 1:CAS:528:DC%2BC1MXmsVymtrg%3D
Cloughesy TF et al. Neoadjuvant anti-PD-1 immunotherapy promotes a survival benefit with intratumoral and systemic immune responses in recurrent glioblastoma Nat. Med. 2019 25 477 486 30742122 6408961 10.1038/s41591-018-0337-7 1:CAS:528:DC%2BC1MXmsVymtL8%3D
Zhao J et al. Immune and genomic correlates of response to anti-PD-1 immunotherapy in glioblastoma Nat. Med. 2019 25 462 469 30742119 6810613 10.1038/s41591-019-0349-y
Begley SL O’Rourke DM Binder ZA CAR T cell therapy for glioblastoma: a review of the first decade of clinical trials Mol. Ther. 2025 10.1016/j.ymthe.2025.03.004 40057825
Goutnik M et al. Advancements in chimeric antigen receptor-expressing T-cell therapy for glioblastoma multiforme: literature review and future directions Neurooncol. Adv. 2024 6 38486856 10939440 vdae025
Hatae R et al. Enhancing CAR-T cell metabolism to overcome hypoxic conditions in the brain tumor microenvironment JCI Insight 2024 10.1172/jci.insight.177141 38386420 11128202
Brown CE et al. Locoregional delivery of IL-13Rα2-targeting CAR-T cells in recurrent high-grade glioma: a phase 1 trial Nat. Med. 2024 30 1001 1012 38454126 11031404 10.1038/s41591-024-02875-1 1:CAS:528:DC%2BB2cXlsV2ksrY%3D
Choi BD et al. Intraventricular CARv3-TEAM-E T cells in recurrent glioblastoma N. Engl. J. Med. 2024 390 1290 1298 38477966 11162836 10.1056/NEJMoa2314390 1:CAS:528:DC%2BB2cXotlOksLY%3D
Bagley SJ et al. Intrathecal bivalent CAR T cells targeting EGFR and IL13Rα2 in recurrent glioblastoma: phase 1 trial interim results Nat. Med. 2024 30 1320 1329 38480922 10.1038/s41591-024-02893-z 1:CAS:528:DC%2BB2cXlvVSis7Y%3D
Chih Y-C et al. Vaccine-induced T cell receptor T cell therapy targeting a glioblastoma stemness antigen Nat. Commun. 2025 16 39893177 11787355 10.1038/s41467-025-56547-w 1:CAS:528:DC%2BB2MXjtVakt7g%3D 1262
Singh, K. et al. IL-7-mediated expansion of autologous lymphocytes increases CD8+ VLA-4 expression and accumulation in glioblastoma models. J. Clin. Invest.https://doi.org/10.1172/jci181471 (2025).
Klichinsky M et al. Human chimeric antigen receptor macrophages for cancer immunotherapy Nat. Biotechnol. 2020 38 947 953 32361713 7883632 10.1038/s41587-020-0462-y 1:CAS:528:DC%2BB3cXlsVeiu74%3D
Martins TA et al. Enhancing anti-EGFRvIII CAR T cell therapy against glioblastoma with a paracrine SIRPγ-derived CD47 blocker Nat. Commun. 2024 15 39521782 11550474 10.1038/s41467-024-54129-w 1:CAS:528:DC%2BB2cXisVOmurbP 9718
Hutter G et al. Microglia are effector cells of CD47–SIRPα antiphagocytic axis disruption against glioblastoma Proc. Natl Acad. Sci. USA 2019 116 997 1006 30602457 6338872 10.1073/pnas.1721434116 1:CAS:528:DC%2BC1MXhtVaqtrc%3D
Gholamin S et al. Irradiation or temozolomide chemotherapy enhances anti-CD47 treatment of glioblastoma Innate Immun. 2020 26 130 137 31547758 10.1177/1753425919876690 1:CAS:528:DC%2BB3cXisFShtb0%3D
Amoozgar Z et al. Targeting Treg cells with GITR activation alleviates resistance to immunotherapy in murine glioblastomas Nat. Commun. 2021 12 33976133 8113440 10.1038/s41467-021-22885-8 1:CAS:528:DC%2BB3MXhtFWgt7nJ 2582
Galvez-Cancino F et al. Regulatory T cell depletion promotes myeloid cell activation and glioblastoma response to anti-PD1 and tumor-targeting antibodies Immunity 2025 58 1236 1253 40280128 10.1016/j.immuni.2025.03.021 1:CAS:528:DC%2BB2MXps1Ogtbo%3D
Pyonteck SM et al. CSF-1R inhibition alters macrophage polarization and blocks glioma progression Nat. Med. 2013 19 1264 1272 24056773 3840724 10.1038/nm.3337 1:CAS:528:DC%2BC3sXhsV2jsr3N
Butowski N et al. Orally administered colony stimulating factor 1 receptor inhibitor PLX3397 in recurrent glioblastoma: an Ivy Foundation Early Phase Clinical Trials Consortium phase II study Neuro Oncol. 2015 18 557 564 26449250 4799682 10.1093/neuonc/nov245
Quail DF et al. The tumor microenvironment underlies acquired resistance to CSF-1R inhibition in gliomas Science 2016 352 27199435 5450629 10.1126/science.aad3018 aad3018
Sun R et al. TREM2 inhibition triggers antitumor cell activity of myeloid cells in glioblastoma Sci. Adv. 2023 9 37172094 10181199 10.1126/sciadv.ade3559 1:CAS:528:DC%2BB3sXhtVaqurjM eade3559
Peshoff MM et al. Triggering receptor expressed on myeloid cells 2 (TREM2) regulates phagocytosis in glioblastoma Neuro Oncol. 2024 26 826 839 38237157 11066944 10.1093/neuonc/noad257 1:CAS:528:DC%2BB2cXivVCqtbzL
Zhong J et al. Distinct roles of TREM2 in central nervous system cancers and peripheral cancers Cancer Cell 2024 42 968 984 38788719 10.1016/j.ccell.2024.05.001 1:CAS:528:DC%2BB2cXhtFCqu7vL
Lorimer IAJ Potential roles for efferocytosis in glioblastoma immune evasion Neurooncol. Adv. 2024 6 38616895 11012614 vdae012
Parker S et al. Immunotoxin–αCD40 therapy activates innate and adaptive immunity and generates a durable antitumor response in glioblastoma models Sci. Transl. Med. 2023 15 36753564 10440725 10.1126/scitranslmed.abn5649 1:CAS:528:DC%2BB3sXivFyrsrg%3D eabn5649
Chen D et al. CTLA-4 blockade induces a microglia–Th1 cell partnership that stimulates microglia phagocytosis and anti-tumor function in glioblastoma Immunity 2023 56 2086 2104 37572655 11800830 10.1016/j.immuni.2023.07.015 1:CAS:528:DC%2BB3sXhs1OgtL3L
Delamarre L Pack M Chang H Mellman I Trombetta ES Differential lysosomal proteolysis in antigen-presenting cells determines antigen fate Science 2005 307 1630 1634 15761154 10.1126/science.1108003 1:CAS:528:DC%2BD2MXitV2isL4%3D
Zhao B Kilian M Bunse T Platten M Bunse L Tumor-reactive T helper cells in the context of vaccination against glioma Cancer Cell 2023 41 1829 1834 37863064 10.1016/j.ccell.2023.09.013 1:CAS:528:DC%2BB3sXitFOqtLrF
Sampson JH et al. Immunologic escape after prolonged progression-free survival with epidermal growth factor receptor variant III peptide vaccination in patients with newly diagnosed glioblastoma J. Clin. Oncol. 2010 28 4722 4729 20921459 3020702 10.1200/JCO.2010.28.6963
Liau LM et al. Association of autologous tumor lysate-loaded dendritic cell vaccination with extension of survival among patients with newly diagnosed and recurrent glioblastoma: a phase 3 prospective externally controlled cohort trial JAMA Oncol. 2023 9 112 121 36394838 10.1001/jamaoncol.2022.5370
Hilf N et al. Actively personalized vaccination trial for newly diagnosed glioblastoma Nature 2019 565 240 245 30568303 10.1038/s41586-018-0810-y 1:CAS:528:DC%2BC1cXisFyksLvN
Keskin DB et al. Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial Nature 2019 565 234 239 30568305 10.1038/s41586-018-0792-9 1:CAS:528:DC%2BC1cXisFyksLvE
Latzer P et al. A real-world observation of patients with glioblastoma treated with a personalized peptide vaccine Nat. Commun. 2024 15 39127809 11316744 10.1038/s41467-024-51315-8 1:CAS:528:DC%2BB2cXhslKntb7M 6870
Tabatabai G et al. Treatment of glioblastoma patients with personalized vaccines outside clinical trials: lessons ignored? Neuro Oncol. 2024 10.1093/neuonc/noae225 38695575 11553953
Kim T-G et al. Immunological factors relating to the antitumor effect of temozolomide chemoimmunotherapy in a murine glioma model Clin. Vaccine Immunol. 2010 17 143 153 19889936 10.1128/CVI.00292-09 1:CAS:528:DC%2BC3cXnsF2iuw%3D%3D
Long GV et al. Neoadjuvant triplet immune checkpoint blockade in newly diagnosed glioblastoma Nat. Med. 2025 10.1038/s41591-025-03512-1 41238915 12705465
Ling AL et al. Serial multiomics uncovers anti-glioblastoma responses not evident by routine clinical analyses Sci. Transl. Med. 2025 17 41061048 10.1126/scitranslmed.adv2881 1:CAS:528:DC%2BB2MXisFynt77P eadv2881
Chevaleyre C et al. Efficient PD-L1 imaging of murine glioblastoma with FUS-aided immunoPET by leveraging FcRn–antibody interaction Theranostics 2023 13 5584 5596 37908736 10614689 10.7150/thno.87168 1:CAS:528:DC%2BB3sXitlOlsLvE
Dar D et al. Imaging PD-L1 in the brain—journey from the lab to the clinic Neuro Oncol. 2025 27 567 582 39470381 10.1093/neuonc/noae190 1:CAS:528:DC%2BB2MXitFKqurrN
Bettegowda C et al. Preanalytical variables and analytes in liquid biopsy approach for brain tumors: a comprehensive review and recommendations from the RANO Group and the Brain Liquid Biopsy Consortium Neuro Oncol. 2025 10.1093/neuonc/noaf140 40884415
De Vleeschouwer S et al. Postoperative adjuvant dendritic cell-based immunotherapy in patients with relapsed glioblastoma multiforme Clin. Cancer Res. 2008 14 3098 3104 18483377 10.1158/1078-0432.CCR-07-4875