Unmasking the potential: mechanisms of neuroinflammatory modulation by oncolytic viruses in glioblastoma.

Glioblastoma, an aggressive and lethal brain tumor, presents enormous clinical challenges, including molecular heterogeneity, high recurrence rates, resistance to conventional therapies, and limited therapeutic penetration across the blood-brain barrier. The glioblastoma microenvironment, characterized by a dynamic interplay of cellular and non-cellular components, is a key driver of tumor growth and therapeutic resistance. Neuroinflammatory cytokines, particularly interleukins and tumor necrosis factor-alpha, play pivotal roles in this microenvironment, contributing to tumor progression and immune evasion. This review highlights oncolytic virotherapy as a promising therapeutic avenue, focusing on its potential to modulate neuroinflammatory responses, induce localized immune reactions, and deliver immunomodulatory factors directly to the tumor site. While encouraging outcomes have been observed, challenges such as overcoming the blood-brain barrier, managing host antiviral immunity, and mitigating potential risks to normal neuronal cells remain critical barriers to clinical translation. By analyzing the intricate interactions of oncolytic viruses with the glioblastoma microenvironment and synthesizing findings from preclinical and clinical trials, this review provides actionable insights into developing personalized and effective therapeutic strategies for this aggressive tumor based on oncolytic virotherapy alone or when using it combined with conventional therapies, immunotherapy, natural killer-cell therapy, chimeric antigen receptor-T cell therapy, and dendritic cell therapy.