CAR T cell therapies for diffuse midline glioma

Diffuse midline glioma (DMG) is a fatal pediatric cancer of the central nervous system (CNS). The location and infiltrative nature of DMG prevents surgical re-section and the benefits of palliative radiotherapy are temporary; median overall survival (OS) is 9-11 months. The tumor immune microenvironment (TIME) is 'cold', and has a dominant immunosuppressive myeloid compartment with low levels of infiltrating lymphocytes and proinflammatory molecules. Because sur-vival statistics have been stagnant for many decades, and therapies targeting the unique biology of DMG are urgently needed, this has prompted the clinical assessment of chimeric antigen receptor (CAR) T cell therapies in this setting. We highlight the current landscape of CAR T cell therapy for DMG, the role the TIME may play in the response, and strategies to overcome treatment obstacles.

Automated summary

Diffuse midline glioma (DMG) is a fatal pediatric cancer that is difficult to treat due to its location and infiltrative nature. Current treatment options have limited effectiveness, and the tumor immune microenvironment (TIME) further reduces the response to therapy. However, chimeric antigen receptor (CAR) T cell therapy shows promise in improving outcomes for DMG patients, and strategies to overcome treatment obstacles are being explored.