Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
John G. Rangos Sr. Research Center, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Antioxid Redox Signal. 2023 Nov;39(13-15):904-922. doi: 10.1089/ars.2022.0187. Epub 2023 Jun 19.
Glioblastoma (GBM), the most common and lethal primary brain tumor with a median survival rate of only 15 months and a 5-year survival rate of only 6.8%, remains largely incurable despite the intensive multimodal treatment of surgical resection and radiochemotherapy. Developing effective new therapies is an unmet need for patients with GBM. Targeted therapies, such as antiangiogenesis therapy and immunotherapy, show great promise in treating GBM based upon increasing knowledge about brain tumor biology. Single-cell transcriptomics reveals the plasticity, heterogeneity, and dynamics of tumor cells during GBM development and progression. While antiangiogenesis therapy and immunotherapy have been highly effective in some types of cancer, the disappointing results from clinical trials represent continued challenges in applying these treatments to GBM. Molecular and cellular heterogeneity of GBM is developed temporally and spatially, which profoundly contributes to therapeutic resistance and tumor recurrence. Deciphering mechanisms of tumor heterogeneity and mapping tumor niche trajectories and functions will provide a foundation for the development of more effective therapies for GBM patients. In this review, we discuss five different tumor niches and the intercellular and intracellular communications among these niches, including the perivascular, hypoxic, invasive, immunosuppressive, and glioma-stem cell niches. We also highlight the cellular and molecular biology of these niches and discuss potential strategies to target these tumor niches for GBM therapy. 39, 904-922.
胶质母细胞瘤(GBM)是最常见和致命的原发性脑肿瘤,中位生存期仅为 15 个月,5 年生存率仅为 6.8%,尽管采用了手术切除和放化疗等强化多模式治疗,但仍基本上无法治愈。对于 GBM 患者,开发有效的新疗法是未满足的需求。基于对脑肿瘤生物学的了解不断增加,靶向治疗(如抗血管生成治疗和免疫治疗)在治疗 GBM 方面显示出巨大的潜力。单细胞转录组学揭示了 GBM 发展和进展过程中肿瘤细胞的可塑性、异质性和动态性。虽然抗血管生成治疗和免疫疗法在某些类型的癌症中非常有效,但临床试验的令人失望结果表明,将这些治疗方法应用于 GBM 仍然存在持续的挑战。GBM 的分子和细胞异质性是随时间和空间发展的,这极大地促成了治疗耐药性和肿瘤复发。破译肿瘤异质性的机制,并绘制肿瘤生态位轨迹和功能图谱,将为开发更有效的 GBM 患者治疗方法提供基础。在这篇综述中,我们讨论了五个不同的肿瘤生态位以及这些生态位之间的细胞间和细胞内通讯,包括血管周围、缺氧、侵袭性、免疫抑制和神经胶质瘤干细胞生态位。我们还强调了这些生态位的细胞和分子生物学,并讨论了针对这些肿瘤生态位进行 GBM 治疗的潜在策略。Trends Cancer. 2023;9(7):904-922.
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