Glioblastoma, the most common primary brain cancer in adults, is characterized by a poor prognosis and resistance to standard treatments. The advent of immunotherapy has revolutionized the treatment of several cancers in recent years but has failed to demonstrate benefit in patients with glioblastoma. Understanding the mechanisms by which glioblastoma exerts tumor-mediated immune suppression in both the tumor microenvironment and the systemic immune landscape is a critical step towards developing effective immunotherapeutic strategies. In this review, we discuss the current understanding of immune escape mechanisms in glioblastoma that compromise the efficacy of immunotherapies, with an emphasis on immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy. In parallel, we review data from preclinical studies that have identified additional therapeutic targets that may enhance overall treatment efficacy in glioblastoma when administered alongside existing immunotherapies.
Radiotherapy is utilized in the treatment of various cancers of the central nervous system and head and neck. Given the high concentration of organs-at-risk in this region, care must be exercised to minimize the dose delivered to these structures. Studies have shown that excessive radiation exposure can adversely impact the eyes, potentially resulting in the loss of their function. For instance, radiation doses greater than 50 Gy have been shown to increase the incidence of retinopathy, and radiation doses as low as 0.5 Gy have been shown to induce cataract formation. In this review, we discuss the ocular complications of radiotherapy used in the treatment of cancers of the central nervous system and head and neck. We then transition to potential strategies to spare the eyes during radiotherapy in an effort to reduce the rates and severity of ocular complications and preserve vision.
Endometrial cancer is the most common gynecologic cancer in the United States and it contributes to the second most gynecologic cancer-related deaths. With upfront surgery, the specific characteristics of both the patient and tumor allow for risk-tailored treatment algorithms including adjuvant radiotherapy and systemic therapy. In this narrative review, we discuss the current radiation treatment paradigm for endometrial cancer with an emphasis on various radiotherapy modalities, techniques, and dosing regimens. We then elaborate on how to tailor radiotherapy treatment courses in combination with other cancer-directed treatments, including chemotherapy and immunotherapy. In conclusion, this review summarizes ongoing research that aims to further individualize radiotherapy regimens for individuals in an attempt to improve patient outcomes.