Reconceptualizing glioblastoma immunotherapy: a four-pillar ...
www.frontiersin.org
June 22, 2026, 10:24 a.m.
Glioblastoma remains a challenging primary brain malignancy characterized by an immunosuppressive tumor microenvironment, low mutational burden, and molecular heterogeneity. Despite immunotherapy successes in other cancers, glioblastoma treatment efficacy remains limited due to impaired antigen presentation, myeloid-mediated immunosuppression, and blood–brain barrier restrictions. This comprehensive review reconceptualizes the immunotherapeutic landscape through four integrated pillars: enhancing antigen presentation, reversing T cell dysfunction, reprogramming the suppressive microenvironment, and engineering effective intracranial delivery. The synthesis encompasses checkpoint blockade, vaccines, oncolytic virotherapy, and adoptive cellular therapies, highlighting recent clinical advances including bispecific T-cell engagers and emerging CAR T cell designs. By identifying resistance mechanisms and therapeutic convergence points, this framework establishes research priorities to overcome glioblastoma's immunological barriers and enable durable antitumor immunity.