News and Views Basic Science: Glioblastoma Stem Cells

European Association of NeuroOncology Magazine 2013; 3 (2): 49-55

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Keywords: cancer stem cell,  glioblastoma

Glioblastomas are highly heterogeneous, infiltrative neoplasms with grave prognoses and five-year survival rates < 10 %. Particular challenges in glioma management include the striking therapeutic resistance of these tumours resulting in rapid and aggressive relapses, invasion of the tumour into normal brain preventing curative surgical resection, distinct intratumoural cellular heterogeneity, and limitations on delivery of therapeutics because of the blood-brain barrier. Surgical resection is beneficial but never curative and commonly followed by chemoradiotherapy plus adjuvant chemotherapy via temozolomide, which offers merely palliation with only modest effects on improving patient outcome. Targeted therapeutics have generally failed for glioblastomas with only modest activity from bevacizumab, an anti-VEGF antibody. Recent advances in glioma research have generated improved models, which better recapitulate the intra- and intertumoural heterogeneity found in patient tumours. These models attempt to address the complex genomic landscape as well as the presence of a cellular hierarchy with a self-renewing, tumourigenic cancer stem cell (CSC) population at the apex. These models also integrate the tumour microenvironment that is composed of extracellular matrix components, stromal cells, vascular/hypoxic niches, and their heterotypic interactions. In this review, we provide a summary of glioma classification, their key features such as angiogenesis and therapeutic resistance, as well as the contribution of glioma CSCs and their microenvironment within the context of glioma biology and behaviour.