The Immune Microenvironment in Chordoma: Implications for Future Treatment.

Liang, Shenquan; Luo, Bangmin; Xie, Shuaiwu; Chen, Aohan; Yao, Jinting; Zhu, Limin; Ouyang, Zhihua; Chu, Zhihe et al. · World Neurosurg · 2025

review · Level V

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Abstract

Chordoma is a rare malignant mesenchymal tumor that is characterized by high local aggressiveness and a high likelihood of postoperative recurrence. Conventional treatment primarily relies on radical surgery followed by adjuvant radiotherapy and chemotherapy. However, due to limitations, such as complex anatomical locations and tumor drug resistance, overall therapeutic efficacy in this context remains suboptimal, thus highlighting the need to explore novel therapies. In recent years, advances in our understanding of the regulatory mechanisms of the immune microenvironment in solid tumors, particularly the significant progress that has been made in research on immune regulation and interactions among various cells within the tumor immune microenvironment, have highlighted new directions for chordoma immunotherapy. This article systematically reviews recent progress in research on tumor cells, immune cells, and stromal cells within the chordoma immune microenvironment. This study aims to elucidate the protumorigenic and antitumorigenic mechanisms of these cells within the tumor microenvironment, thereby providing a theoretical foundation for the future development of precise immunotherapy strategies targeting the tumor immune microenvironment.

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