Kisby Thomas, Borst Gerben R, Coope David J, Kostarelos Kostas
Centre for Nanotechnology in Medicine, Faculty of Biology & Medicine and Health, University of Manchester, Manchester, UK.
Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK.
Nat Rev Clin Oncol. 2025 May 14. doi: 10.1038/s41571-025-01020-2.
Surgical resection is the first stage of treatment for patients diagnosed with resectable glioblastoma and is followed by a combination of adjuvant radiotherapy and systemic single-agent chemotherapy, which is typically commenced 4-6 weeks after surgery. This delay creates an interval during which residual tumour cells residing in the resection margin can undergo uninhibited proliferation and further invasion, even immediately after surgery, thus limiting the effectiveness of adjuvant therapies. Recognition of the postsurgical resection margin and peri-marginal zones as important anatomical clinical targets and the need to rethink current strategies can galvanize opportunities for local, intraoperative approaches, while also generating a new landscape of innovative treatment modalities. In this Perspective, we discuss opportunities and challenges for developing locoregional therapeutic strategies to target the glioblastoma resection margin as well as emerging opportunities offered by nanotechnology in this clinically transformative setting. We also discuss how persistent barriers to clinical translation can be overcome to offer a potential path forward towards broader acceptability of such advanced technologies.
手术切除是诊断为可切除胶质母细胞瘤患者的第一阶段治疗,随后是辅助放疗和全身单药化疗联合使用,通常在术后4至6周开始。这种延迟产生了一个间隔期,在此期间,即使在手术后立即存在于切除边缘的残留肿瘤细胞也可以不受抑制地增殖并进一步侵袭,从而限制了辅助治疗的效果。将术后切除边缘和边缘周围区域视为重要的解剖学临床靶点,以及重新思考当前策略的必要性,可以激发局部术中方法的机会,同时也会产生创新治疗模式的新前景。在这篇观点文章中,我们讨论了开发针对胶质母细胞瘤切除边缘的局部区域治疗策略的机会和挑战,以及纳米技术在这种临床变革环境中提供的新机会。我们还讨论了如何克服临床转化的持续障碍,为这些先进技术更广泛的可接受性提供一条潜在的前进道路。