Abstract
Glioblastoma (GBM) is one of the most aggressive and lethal human brain tumors. At
present, GBMs are divided in primary and secondary on the basis of the mutational status of the
isocitrate dehydrogenase (IDH) genes. In addition, IDH1 and IDH2 mutations are considered crucial
to better define the prognosis. Although primary and secondary GBMs are histologically
indistinguishable, they retain distinct genetic alterations that account for different evolution of the
tumor. The high invasiveness, the propensity to disperse throughout the brain parenchyma, and the
elevated vascularity make these tumors extremely recidivist, resulting in a short patient median
survival even after surgical resection and chemoradiotherapy. Furthermore, GBM is considered an
immunologically cold tumor. Several studies highlight a highly immunosuppressive tumor
microenvironment that promotes recurrence and poor prognosis. Deeper insight into the tumor
immune microenvironment, together with the recent discovery of a conventional lymphatic system
in the central nervous system (CNS), led to new immunotherapeutic strategies. In the last two
decades, experimental evidence from different groups proved the existence of cancer stem cells
(CSCs), also known as tumor-initiating cells, that may play an active role in tumor development and
progression. Recent findings also indicated the presence of highly infiltrative CSCs in the
peritumoral region of GBM. This region appears to play a key role in tumor growing and recurrence.
However, until recently, few studies investigated the biomolecular characteristics of the peritumoral
tissue. The aim of this review is to recapitulate the pathological features of GBM and of the
peritumoral region associated with progression and recurrence.
Lingua originale | English |
---|---|
pagine (da-a) | N/A-N/A |
Numero di pagine | 19 |
Rivista | Cancers |
DOI | |
Stato di pubblicazione | Pubblicato - 2019 |
Keywords
- GBM
- biomarkers
- cancer stem cells
- central nervous system
- chemotherapy
- glioma
- microRNA
- peritumoral tissue