# Precision Immunotherapeutics for Glioblastoma: Current Approaches and Emerging Strategies in 2026

**Authors:** James Poe, Claire Kim, Campbell Coleman, Hieu Nguyen, Vaithish Velazhahan, Brandon Bergsneider, Vivek Sanker, Samuel Kim, Yijiang Chen, Matthew Abikenari, John Choi, Michael Lim

PMC · DOI: 10.3390/cells15060561 · 2026-03-20

## TL;DR

This review explores new strategies for glioblastoma immunotherapy by integrating systems biology and advanced technologies to better understand and target the complex tumor-immune interactions.

## Contribution

The paper introduces a systems biology framework for next-generation glioblastoma immunotherapy, moving beyond single-axis approaches.

## Key findings

- The tumor microenvironment's immunosuppressive nature and spatial heterogeneity limit immunotherapy efficacy in glioblastoma.
- Systems biology approaches reveal how immune system dynamics and tumor-immune resource competition influence treatment outcomes.
- Advanced technologies like spatial transcriptomics and AI analytics are enabling predictive biomarkers and rational combination therapies.

## Abstract

Glioblastoma (GBM) persists as one of the greatest challenges in the treatment of human cancer, despite extensive efforts to leverage the therapeutic potential of immunotherapy. While checkpoint blockade and other forms of immunotherapy have revolutionized the treatment of various cancers, their therapeutic efficacy in GBM has been hindered by the profound immunosuppressive environment, spatial heterogeneity, and dynamic immune metabolic challenges associated with the tumor microenvironment. In this review, we will synthesize recent advances and insights to develop a next-generation framework for GBM immunotherapy based on systems biology approaches to understanding the complex interplay between GBM and the immune system, as opposed to single-axis approaches to immune activation and modulation. We will discuss how the functional competence of the interferon system, myeloid antigen presentation status, T-cell clone status, spatial organization of the immune microenvironment, and resource competition between GBM and the immune system dictate therapeutic responsiveness. Furthermore, the current paper elucidates how recent advances in spatial transcriptomics, single-cell analysis, and high-parameter imaging enable us to understand how immune phenotype status varies across GBM regions and treatment status, and how this information can be used to develop predictive and pharmacodynamic biomarkers of therapeutic efficacy and failure. We will then discuss how these advances form the basis for rational combination approaches to GBM immunotherapy, which involve the integration of checkpoint blockade with metabolic reprogramming, myeloid modulation, and interferon system reactivation, and how artificial intelligence-based analytics and adaptive clinical trial design can guide the development of biomarker-based therapeutic selection approaches.

## Linked entities

- **Diseases:** Glioblastoma (MONDO:0018177), GBM (MONDO:0018177)

## Full-text entities

- **Genes:** CD274 (CD274 molecule) [NCBI Gene 574058] {aka PDL1}, CD70 (CD70 molecule) [NCBI Gene 970] {aka CD27-L, CD27L, CD27LG, LPFS3, TNFSF7, TNLG8A}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, IDO1 (indoleamine 2,3-dioxygenase 1) [NCBI Gene 3620] {aka IDO, IDO-1, INDO}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, PPARD (peroxisome proliferator activated receptor delta) [NCBI Gene 5467] {aka FAAR, NR1C2, NUC1, NUCI, NUCII, PPARB}, IL13RA2 (interleukin 13 receptor subunit alpha 2) [NCBI Gene 3598] {aka CD213A2, CT19, IL-13R, IL13BP}, IL11 (interleukin 11) [NCBI Gene 3589] {aka AGIF, IL-11}, METRNL (meteorin like, glial cell differentiation regulator) [NCBI Gene 284207], MTOR (mechanistic target of rapamycin kinase) [NCBI Gene 2475] {aka FRAP, FRAP1, FRAP2, RAFT1, RAPT1, SKS}, FOXP3 (forkhead box P3) [NCBI Gene 50943] {aka AIID, DIETER, IPEX, JM2, PIDX, XPID}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, Cxcl15 (C-X-C motif chemokine ligand 15) [NCBI Gene 20309] {aka Il8, Scyb15, lungkine, weche}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 21803] {aka TGF-beta1, TGFbeta1, Tgfb, Tgfb-1}, CTLA4 (cytotoxic T-lymphocyte associated protein 4) [NCBI Gene 1493] {aka ALPS5, CD, CD152, CELIAC3, CTLA-4, GRD4}, Il10 (interleukin 10) [NCBI Gene 16153] {aka CSIF, If2a, Il-10}, Il13ra2 (interleukin 13 receptor, alpha 2) [NCBI Gene 16165] {aka CD213a2, IL-13R-alpha-2}, S (surface glycoprotein) [NCBI Gene 43740568] {aka spike glycoprotein}, CTLA4 (cytotoxic T-lymphocyte associated protein 4) [NCBI Gene 397286], TRBV20OR9-2 (T cell receptor beta variable 20/OR9-2 (non-functional)) [NCBI Gene 6962] {aka CDR3, TCRBV20S2, TCRBV2O, TCRBV2S2O}, CCL2 (C-C motif chemokine ligand 2) [NCBI Gene 6347] {aka GDCF-2, HC11, HSMCR30, MCAF, MCP-1, MCP1}, Tgfbr2 (transforming growth factor, beta receptor II) [NCBI Gene 21813] {aka 1110020H15Rik, DNIIR, RIIDN, TBR-II, TbetaR-II, TbetaRII}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, TNFSF10 (TNF superfamily member 10) [NCBI Gene 8743] {aka APO2L, Apo-2L, CD253, TANCR, TL2, TNLG6A}, LAG3 (lymphocyte activating 3) [NCBI Gene 100125962] {aka CD223, LAG-3}, Lag3 (lymphocyte-activation gene 3) [NCBI Gene 16768] {aka CD223, LAG-3, Ly66}, ARG1 (arginase 1) [NCBI Gene 383], Nr1i3 (nuclear receptor subfamily 1, group I, member 3) [NCBI Gene 12355] {aka CAR, CAR-beta, Care2, ESTM32, MB67}, NOS2 (nitric oxide synthase 2) [NCBI Gene 4843] {aka HEP-NOS, INOS, NOS, NOS2A}, CXCL12 (C-X-C motif chemokine ligand 12) [NCBI Gene 6387] {aka IRH, PBSF, SCYB12, SDF1, TLSF, TPAR1}, TDO2 (tryptophan 2,3-dioxygenase) [NCBI Gene 6999] {aka HYPTRP, TDO, TO, TPH2, TRPO}, ENTPD1 (ectonucleoside triphosphate diphosphohydrolase 1) [NCBI Gene 953] {aka ATP-DPH, ATPDase, CD39, NTPDase-1, SPG64}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, CIITA (class II major histocompatibility complex transactivator) [NCBI Gene 4261] {aka C2TA, CIITAIV, MHC2D1, MHC2TA, NLRA}, CD28 [NCBI Gene 100738615], RB1 (RB transcriptional corepressor 1) [NCBI Gene 5925] {aka OSRC, PPP1R130, RB, p105-Rb, p110-RB1, pRb}, PVR (PVR cell adhesion molecule) [NCBI Gene 5817] {aka CD155, HVED, NECL5, Necl-5, PVS, TAGE4}, SLC7A5 (solute carrier family 7 member 5) [NCBI Gene 8140] {aka 4F2LC, CD98, D16S469E, E16, LAT1, MPE16}, Cxcl10 (C-X-C motif chemokine ligand 10) [NCBI Gene 15945] {aka C7, CRG-2, INP10, IP-10, IP10, Ifi10}, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) [NCBI Gene 5290] {aka CCM4, CLAPO, CLOVE, CWS5, HMH, MCAP}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, Ifnb1 (interferon beta 1, fibroblast) [NCBI Gene 15977] {aka IFN-beta, IFNB, If1da1, Ifb}, Fn1 (fibronectin 1) [NCBI Gene 14268] {aka E330027I09, Fn, Fn-1}, IL12B (interleukin 12B) [NCBI Gene 3593] {aka CLMF, CLMF2, IL-12B, IMD28, IMD29, NKSF}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, Cd19 (CD19 antigen) [NCBI Gene 12478], Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, ANXA1 (annexin A1) [NCBI Gene 301] {aka ANX1, LPC1}, FUS (FUS RNA binding protein) [NCBI Gene 2521] {aka ALS6, ETM4, FUS1, HNRNPP2, POMP75, TLS}, AHR (aryl hydrocarbon receptor) [NCBI Gene 196] {aka FVH3, RP85, bHLHe76}, CXCR2 (C-X-C motif chemokine receptor 2) [NCBI Gene 3579] {aka CD182, CDw128b, CMKAR2, IL8R2, IL8RA, IL8RB}, CD86 (CD86 molecule) [NCBI Gene 397441], Havcr2 (hepatitis A virus cellular receptor 2) [NCBI Gene 171285] {aka TIM-3, Tim3, Timd3}, HIF1A (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 3091] {aka HIF-1-alpha, HIF-1A, HIF-1alpha, HIF1, HIF1-ALPHA, MOP1}, PTPRZ1 (protein tyrosine phosphatase receptor type Z1) [NCBI Gene 5803] {aka HPTPZ, HPTPzeta, PTP-ZETA, PTP18, PTPRZ, PTPZ}, FPR1 (formyl peptide receptor 1) [NCBI Gene 2357] {aka FMLP, FPR}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, CD80 (CD80 molecule) [NCBI Gene 397161] {aka B7-1}, CSF3 (colony stimulating factor 3) [NCBI Gene 1440] {aka C17orf33, CSF3OS, GCSF}
- **Diseases:** Hypoxia (MESH:D000860), GBM (MESH:D005909), Cancer (MESH:D009369), mesenchymal tumor (MESH:C535700), cerebrovascular diseases (MESH:D002561), meningiomas (MESH:D008579), viral (MESH:D014777), lymphopenia (MESH:D008231), melanoma (MESH:D008545), lactic acidosis (MESH:D000140), glioma (MESH:D005910), traumatic brain injuries (MESH:D000070642), inflammation (MESH:D007249), thrombosis (MESH:D013927), solid (MESH:D018250), brain malignancies (MESH:D001932), interferon (MESH:C535530), neurological disorders (MESH:D009461), Hypoxic (MESH:D002534), hyperthermia (MESH:D005334), lung, hematologic, breast, and renal cancer (MESH:D001943), necrotic (MESH:D009336), epilepsy (MESH:D004827), stroke (MESH:D020521), infection (MESH:D007239), injury to (MESH:D014947), TAMs (MESH:D000072716), non-small cell lung cancer (MESH:D002289), cytotoxicity (MESH:D064420), MDSCs (OMIM:601308)
- **Chemicals:** bevacizumab (MESH:D000068258), hydrogen peroxide (MESH:D006861), atezolizumab (MESH:C000594389), cemiplimab (MESH:C000627974), TMZ (MESH:D000077204), ROS (MESH:D017382), pembrolizumab (MESH:C582435), Indoximod (MESH:C525396), pyruvate (MESH:D019289), Kyn (MESH:D007737), steroid (MESH:D013256), oxygen (MESH:D010100), lactate (MESH:D019344), cholesterol (MESH:D002784), 8R-70CAR (-), Trp (MESH:D014364), NIVO (MESH:D000077594), lipid (MESH:D008055), durvalumab (MESH:C000613593), adenosine (MESH:D000241)
- **Species:** Human alphaherpesvirus 1 (Herpes simplex virus type 1, no rank) [taxon 10298], Enterovirus C (no rank) [taxon 138950], Cytomegalovirus (genus) [taxon 10358], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC13025625/full.md

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Source: https://tomesphere.com/paper/PMC13025625