Overview of Vaccine Strategies Against Epidermal Growth Factor Receptor in Brain Tumors

Patients with glioblastoma (GBM) have a dismal prognosis despite the most aggressive multimodal regimen affording a median survival of barely 15 months. Thus, the field is in desperate need of therapies that specifically and safely target these tumors. Arming the immune system is an alternative approach, as its cellular effectors can be called into action with incredible specificity and offer an additional capacity for memory, which no systemic therapy can possess. Several of these immunotherapies have been well understood in solid tumors such as melanoma, lung, and breast carcinoma and have now been introduced in GBM over the past two decades. The advent of dendritic cell vaccines, adoptive cell transfer with tumor-specific T cells or chimeric antigen receptors, bi-specific T-cell engagers, and now combinatorial therapy with immune checkpoint inhibitors have all yielded dramatic results. This chapter outlines the evolution of these therapies in targeting the mutated EGFR in GBM and further discusses current barriers in realizing immunotherapy as a widely applicable regimen for this highly resistant tumor.