Researchers at Uppsala University in Sweden have discovered lymph node-like structures close to the tumour in brain cancer patients, where immune cells can be activated to attack the tumour.

In their study published in the journal Nature Communications, the researchers found that immunotherapy enhanced the formation of these structures. This discovery suggests new opportunities to regulate the anti-tumour response of the immune system. Glioma is a deadly brain tumour with a dismal prognosis. One reason why brain tumours are very hard to treat is that our immune system, which is designed to detect and destroy foreign cells including cancer cells, cannot easily reach the tumour site due to the barriers that surround the brain.

To fight a developing tumour, killer immune cells such as T lymphocytes must be activated and primed in our lymph nodes, before travelling to the tumour site to effectively kill the cancer cells. Because of the barriers around the brain, it is a challenging process for T lymphocytes to reach the tumour. The researchers describe their discovery of structures similar to lymph nodes in the brain where T lymphocytes could be activated.

"It was extremely exciting to discover for the first time the presence of lymph node-like structures in glioma patients. These structures are known as tertiary lymphoid structures (TLS) and they are not found in healthy individuals. They have all the components needed to support lymphocyte activation on-site which means that they could have a positive effect on the anti-tumour immune response," said Alessandra Vaccaro, PhD student at the Department of Immunology, Genetics and Pathology.

"Learning that immunotherapies can modulate the formation of tertiary lymphoid structures in the brain offers exciting opportunities to find new ways of regulating the anti-tumour immune response in glioma," said Anna Dimberg.
aCD40 is currently being tested to treat brain tumours in a number of clinical trials. In the study now published, the researchers found that while aCD40 boosted TLS formation, it also counterproductively inhibited the tumour-killing ability of the T lymphocytes. The study has therefore provided important insights into the multifaceted effects of aCD40 therapy.