Cancer neuroscience: Mechanisms to medicine

The nervous system is now recognized as an enabling hallmark of cancer biology. Neural inputs drive tumor growth in both central nervous system tumors and extracranial tumors through different mechanisms, including synaptic signaling, adrenergic regulation, perineural invasion, neuropeptides, immune remodeling, and bioelectric mechanisms. These insights have facilitated repurposing of neuroactive agents that are now in clinical trials as adjuncts to standard cancer therapy. The central translational challenge now is how to match the right neural circuit to the right patient and to pair appropriate neuromodulators with immunotherapy in combinations designed to restore, rather than merely supplement, antitumor immunity.