Fig. 3.

T cells as immunotherapeutic agents. T cells can be deployed as therapeutic modalities, serving as cancer vaccine inducers, cytotoxic effectors, or as targets for immune checkpoint de-repression. Bispecific T cell engager (BiTE) therapy uses a bispecific antibody that binds to CD3 and a tumor specific antigen, activating T cells to lyse the tumor. Oncolytic viruses cause direct tumor cell lysis, but can also be designed to stimulate the immune system by producing immunostimulatory cytokines or through tumor cell-mediated viral antigen presentation. Immune checkpoint inhibitors target Programmed Death Receptor-1 (PD-1) or Cytotoxic T-lymphocyte antigen 4 (CTLA-4) receptors for PDL-1 and B7 respectively, on T cells to promote cell cycle arrest and T cell exhaustion. Many tumors express PD-L1, which suppresses cytotoxic T cell function. Chimeric Antigen Receptor (CAR) T cells are autologous or donor T cells primed with an antigen receptor recognizing one or multiple glioma-expressed antigens or neoantigens. Cancer vaccines bolster cytotoxic T cell responses by overloading the immune system with neoantigens (peptides), either alone or presented on dendritic cells (DCs). With an increase in neoantigen content, antigen-presenting cells (APCs) can express these neoantigens on their cell surface, thus enabling T cells to generate more robust anti-tumoral responses. Created with BioRender.