A neurocentric perspective on glioma invasion

Malignant gliomas are notoriously difficult cancers to treat. The majority of current therapeutics target the traditional oncological traits of glioma cells. In this Review, Cuddapahet al. explore the unique biology of glioma cells and propose novel, brain-specific therapeutic targets. Malignant gliomas are devastating tumours that frequently kill patients within 1 year of diagnosis. The major obstacle to a cure is diffuse invasion, which enables tumours to escape complete surgical resection and chemo- and radiation therapy. Gliomas use the same tortuous extracellular routes of migration that are travelled by immature neurons and stem cells, frequently using blood vessels as guides. They repurpose ion channels to dynamically adjust their cell volume to accommodate to narrow spaces and breach the blood–brain barrier through disruption of astrocytic endfeet, which envelop blood vessels. The unique biology of glioma invasion provides hitherto unexplored brain-specific therapeutic targets for this devastating disease.