Research Progress in Immunotherapy and the Impact of Traditional Chinese Medicine on Glioblastoma

Glioblastoma (GBM), the most common and aggressive primary brain tumor of the central nervous system, is characterized by significant heterogeneity and rapid growth. Its high vascularity, deep infiltration into the brain parenchyma, and indistinct boundaries limit the success of conventional treatments such as surgery, chemotherapy, and radiotherapy. In this scenario, immunotherapy, which aims to enhance the body's immune response against tumors, has become a leading approach to cancer treatment. Key immunotherapeutic modalities include checkpoint inhibitors, adoptive T cell therapy, peptide vaccines, dendritic cell vaccines, and oncolytic viruses. Despite numerous clinical successes, challenges such as the blood-brain barrier, GBM heterogeneity, and the tumor microenvironment complicate immunotherapy for brain tumors. This review explores the GBM microenvironment, angiogenic mechanisms, and the roles of key cellular and molecular components in tumor progression. It also examines emerging immunotherapeutic strategies targeting these pathways. Drawing upon the principles of traditional Chinese medicine, particularly the concept of "fortifying the body's resistance and eliminating pathogenic factors," herbal medicine is presented as a holistic therapeutic approach characterized by multi-pathway, multitarget, and multifunctional effects. Herbal medicine can not only alleviate clinical symptoms and improve quality of life for patients with tumors but also mitigate side effects from radiotherapy and chemotherapy, potentially prolonging survival. This review further clarifies how these herbs modulate the immune system to combat tumors, supporting the development of new combinatorial approaches that use herbal medicine and immunotherapy for GBM.