Neuro-oncology最新文献

{"title":"Developing an advanced risk stratification model for pediatric intracranial ependymoma based on the prospective trial E-HIT2000 and subsequent registries.","authors":"Katja von Hoff, Denise Obrecht-Sturm, David R Ghasemi, Janna Wenning, Martin Mynarek, Nicolas U Gerber, Martin Benesch, Björn O Juhnke, Brigitte Bison, Monika Warmuth-Metz, Beate Timmermann, Andreas Faldum, Stephan Tippelt, Gudrun Fleischhack, Michael Grotzer, Pablo Hernáiz Driever, Andreas Beilken, Martin Ebinger, Norbert Graf, Michael C Frühwald, Irene Schmid, Irene Slavc, Arend Koch, Markus Bergmann, Christian Hagel, Roland Coras, Ingmar Blümcke, Guido Reifenberger, Jörg Felsberg, Kathy Keyvani, Patrick N Harter, Marco Prinz, Ori Staszewski, Till Acker, Christine Stadelmann-Nessler, Christian Hartmann, Andreas von Deimling, Clemens Sommer, Martin Hasselblatt, Markus J Riemenschneider, Camelia-Maria Monoranu, Elisabeth Rushing, Christine Haberler, Marcel Kool, Martin Sill, Stefan M Pfister, Ulrich Schüller, Torsten Pietsch, Rolf D Kortmann, Robert Kwiecien, Hendrik Witt, Kristian W Pajtler, Stefan Rutkowski","doi":"10.1093/neuonc/noaf218","DOIUrl":"https://doi.org/10.1093/neuonc/noaf218","url":null,"abstract":"<p><strong>Background: </strong>Current treatment strategies for pediatric intracranial ependymoma do not consider molecular heterogeneity. Here, we evaluated molecular group-specific determinants of outcome and developed an improved risk stratification model.</p><p><strong>Methods: </strong>Patients aged 0-21 years with localized intracranial ependymoma were enrolled into the prospective clinical trial E-HIT2000. Treatment included maximum safe surgery, local radiotherapy, and chemotherapy, stratified according to age, histology and, following a major amendment, residual tumor. Clinical data were analyzed in a pooled molecularly annotated cohort with data from patients treated analogously within subsequent registries.</p><p><strong>Results: </strong>For 291 trial patients, the 5-year PFS and OS were 62±3% and 81±2%, respectively. For the molecularly annotated pooled cohort (n = 228), 5-year PFS/OS were: EPN-PFA (n = 146): 45±4%/77±4%; EPN-PFB (n = 19): 90±7%/100%; EPN-ZFTA (n = 59): 64±7%/86±5%; EPN-YAP1 (n = 4): 50±25%/100%. Patients with EPN-PFA without molecular risk factors (1q gain, and/or subtype EPN-PFA1c/d/e,2a), with complete resection, and postoperative radiotherapy showed favorable outcomes (5-year PFS/OS 75±10%/92±7%). For patients with EPN-PFA with molecular risk factors, prognosis was poor irrespective of residual tumor status (5-year PFS/OS: 33±6%/64±6%). Among EPN-ZFTA, 11/59 tumors were classified as EPN-ZFTA with alternative fusions, associated with inferior PFS (5-year PFS/OS: 36±15%/91±9%). For EPN-ZFTA-RELA, homozygous deletions of CDKN2A were associated with unfavorable outcomes (4-year PFS/OS: 19±16%/57±18% vs. 79±7%/97±3%, p = 0.0001). Finally, we developed a novel stratification model that discriminates standard and intermediate risk patients from those at high risk (p < 0.0001 for PFS and OS).</p><p><strong>Conclusions: </strong>These results strongly suggest the inclusion of molecular parameters into stratification, and the use of distinct treatment strategies within future ependymoma trials.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"YBX1&YBX3 as novel targets to potentiate immune checkpoint blockade response in gliomas.","authors":"Heba Ali, Ningjia Zhou, Li Chen, Levi van Hijfte, Rima Tulaiha, Vivekanudeep Karri, Yalu Zhou, Karl Habashy, Victor A Arrieta, Kwang-Soo Kim, Joseph Duffy, Ragini Yeeravalli, Deanna M Tiek, Xiao Song, Snehasis Mishra, Craig Horbinski, Catalina Lee-Chang, Atique Ahmed, Lu Wang, Dieter Henrik Heiland, Adam M Sonabend, Crismita Dmello","doi":"10.1093/neuonc/noaf227","DOIUrl":"https://doi.org/10.1093/neuonc/noaf227","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma (GBM) exhibits profound resistance to CD8⁺ T cell-mediated killing, yet the tumor-intrinsic mechanisms driving this immune evasion remain poorly defined. Our earlier study revealed Checkpoint Kinase 2 (Chek2) as the driver of CD8+ T cell resistance. This study investigates the immunomodulatory program exerted by the CHK2-YBX1&YBX3 regulatory hub.</p><p><strong>Methods: </strong>Protein-protein interactions were investigated through immunoprecipitation (IP) followed by mass spectrometry (MS) and phosphoproteomics. Single gene knockout of CHEK2, Y-box-binding protein 1 (YBX1), and Y-box-binding protein 3 (YBX3) were generated in human and mouse glioma cells. Transcriptomic and epigenetic alterations were characterized by bulk RNA sequencing and chromatin immunoprecipitation sequencing (ChIP-seq). Single-cell RNA sequencing and spatial transcriptomics analysis were performed to evaluate CHK2-YBX1&YBX3 related phenotype in human GBM tumors. In vivo survival studies were conducted to assess the therapeutic potential of CHK2-YBX1&YBX3 degradation and immune checkpoint blockade (ICB).</p><p><strong>Results: </strong>CHK2, YBX1, and YBX3 exhibited reciprocal positive regulation and depletion of any of these genes resulted in derepression of pro-inflammatory gene expression. Pharmacological inhibition with the drug targeting YBX1 led to degradation of the CHK2-YBX1&YBX3 hub accompanied by enhanced antigen presentation and antigen-specific CD8⁺ T cell proliferation. Combination therapy targeting CHK2-YBX1&YBX3 hub and ICB significantly improved survival in preclinical glioma models.</p><p><strong>Conclusions: </strong>These findings define a novel glioma-intrinsic immunosuppressive program and proposes targeting the CHK2-YBX1&YBX3 hub to potentiate response to ICB in glioma.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Bayesian Reappraisal of ACNS0332 and ACNS0334 Strengthens Subgroup Treatment Effects in High-Risk Pediatric Group 3 Medulloblastoma.","authors":"Guolian Kang, Sarah E S Leary, Arzu Onar-Thomas, Yimei Li","doi":"10.1093/neuonc/noaf212","DOIUrl":"https://doi.org/10.1093/neuonc/noaf212","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell profiling of peripheral and local immune compartments reveal unique genotype-independent prognostic immune signatures across IDH-stratified glioma.","authors":"Jonathan H Sussman, Anthony R Cillo, Sajeev Kohli, Carly Cardello, Jonathan Patterson, Ebrar Akca, Angelo Angione, David Moon, Katharine Krueger, Ali Ghamari, Emily Xu, Jessica Xu, Antonio C Tarbay, Alex Li, Bhargavi R Budihal, Xiaoran Zhang, Omar Elghawy, Wojciech K Panek, Prajwal Rajappa, Kai Tan, Dario A A Vignali, Tullia C Bruno, Nduka M Amankulor","doi":"10.1093/neuonc/noaf206","DOIUrl":"https://doi.org/10.1093/neuonc/noaf206","url":null,"abstract":"<p><strong>Background: </strong>Solid tumor immune suppression requires cooperation of tumor cells, local immune cells, peripheral circulating immune cells, and evolution of immune cell trajectories between peripheral and local environments. This study addresses a significant knowledge gap by characterizing peripheral and local immune environments in IDH Mutant (IDH-Mut) and IDH wildtype (IDH-WT) gliomas and defines novel immunological states with prognostic relevance across the glioma landscape.</p><p><strong>Methods: </strong>We analyzed local and peripheral immune phenotypes in a cohort of 18 (6 IDH-Mut and 12 IDH-WT) gliomas with distinct genetic characteristics using paired human tumor and peripheral blood mononuclear cells (PBMCs) with single-cell RNA-sequencing (scRNA-seq).</p><p><strong>Results: </strong>Our analyses revealed unique intratumoral and peripheral immune cellular ontogenies, including naïve CD4+ T cell enrichment in the IDH-Mut peripheral immune compartment, monocyte enrichment in IDH-WT glioma PBMCs, and emergence of a unique population of GZMH+ CD8+ T cells preferentially in the IDH-Mut microenvironment. Additionally, we found upregulation of TNF-α signaling and inflammatory response pathways in IDH-Mut-glioma-associated peripheral lymphoid cells versus IDH-WT tumors and identified a novel population of microglia-like cells in the peripheral blood of glioma patients with complement-interfacing characteristics. Applying intratumoral transcriptomic deconvolution via The Cancer Genome Atlas revealed genotype-independent, prognostic immune signatures across the malignant glioma landscape.</p><p><strong>Conclusions: </strong>This study reveals variable expression of immune phenotypes in adult gliomas stratified by IDH status and characterizes immune compartment and genotype-dependent differences in the immunologic glioma landscape. These genotype-dependent, tumor and circulating immune ontogenies should guide future diagnostic and immunotherapeutic considerations in malignant glioma.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple patient-derived glioblastoma models reveal synthetic lethality through concurrent PI3K and CDK4/6 inhibition by blocking trans-active cooperation.","authors":"Jing Zhang, Xu Chen, Meng Cheng, Jingzhe Wang, Yueyao Wu, Han Xie, Chunyu Zhang, Honghao Wang, Ying Pang, Tongjie Ji, Yuntong Yang, Junyu Yang, Siyi Xu, Zhigang Wang, Qi Wang, Min Liu, Chunlong Zhong","doi":"10.1093/neuonc/noaf224","DOIUrl":"https://doi.org/10.1093/neuonc/noaf224","url":null,"abstract":"<p><strong>Background: </strong>Dysregulation of the PI3K signaling pathway has been recognized as a pivotal oncogenic driver in GBM progression. Although PI3K inhibitors have demonstrated initial therapeutic efficacy, the development of resistance through compensatory upregulation of alternative signaling pathways substantially limits their clinical benefits. However, the molecular mechanisms underlying this resistance to PI3K monotherapy in GBM remain incompletely understood.</p><p><strong>Methods: </strong>Multiple patient-derived glioblastoma models including organoids (GBOs), primary dissociated cells (PDCs) and xenografts (PDCX) were established as clinically relevant platforms to evaluate the feasibility of tailored therapy. Comprehensive molecular profiling and functional analyses were conducted across these patient-derived models. RNA sequencing, mass spectrometry, DNA spreading assays, HR /NHEJ reporter assays and mIF were performed to elucidate the molecular underpinnings of PI3K and CDK4/6 co-activation in driving tumor evolution, and to reveal the synthetic lethality efficacy of the concurrent strategy.</p><p><strong>Results: </strong>Our findings demonstrate that PI3K monoinhibition induces aberrant CDK4/6 activation, and co-activation of PI3K-CDK4/6 signaling positively correlates with monotherapy resistance, which is driven by tumor evolution. The concurrent strategies with PI3K and CDK4/6 inhibition synergistically achieve therapeutic efficacy in suppressing the growth of GBOs, PDCs and PDCX. Mechanistically, insufficient DNA damage response under PI3Ki mono-therapy upregulated CDK4/6, driving aberrant cell cycle progression. The small-molecule inhibitors paxalisib and ribociclib potently suppress tumor proliferation, which induced persistent replication stress and genomic instability.</p><p><strong>Conclusions: </strong>Employing multiple patient-derived models, our study uncovers clinically relevant PI3Ki resistance mechanisms and advocates a rationale for synthetic lethality through combined PI3K-CDK4/6 inhibition, offering substantial therapeutic potential for GBM patients.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Successful use of response leads to ONC201 approval\".","authors":"Louis Burt Nabors","doi":"10.1093/neuonc/noaf222","DOIUrl":"https://doi.org/10.1093/neuonc/noaf222","url":null,"abstract":"","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scalable Tracking of Symptoms in the Electronic Health Record using Large Language Models in Patients with Central Nervous System Cancers Undergoing Therapy.","authors":"John Y Rhee, Zachary Tentor, Thomas Sounack, Brigitte Durieux, Paul J Miller, Rameen Beroukhim, Charlotta Lindvall","doi":"10.1093/neuonc/noaf223","DOIUrl":"https://doi.org/10.1093/neuonc/noaf223","url":null,"abstract":"<p><strong>Background: </strong>Advances in large language models (LLMs) provide a means for scalable tracking of patient symptoms in clinical trials and post-marking surveillance using the electronic health record (EHR). Therefore, we sought to validate symptoms extracted from the EHR using a LLM to scale symptom extraction from the EHR.</p><p><strong>Methods: </strong>Across a dataset of 499 randomly chosen clinical notes from patients seen in a neuro-oncology clinic, GPT-4o annotated symptoms (headache, fatigue, nausea, anxiety, difficulties sleeping, numbness and tingling, rash, constipation, and diarrhea) with an average sensitivity and specificity of 0.97 relative to expert manual review. We then applied the LLM to an external dataset of 51,541 notes representing 1,642 patients to obtain real-world symptom prevalence for temozolomide, bevacizumab, lomustine, immune checkpoint inhibitors (ICI), and methotrexate.</p><p><strong>Results: </strong>In the external dataset, the average number of symptoms per note was 3.92, and the most common symptom was fatigue (83% of patients). Surprisingly, patients receiving ICIs suffered from the most symptoms (mean = 4.68) and those receiving methotrexate had the least (mean = 2.92). We also found that the prevalence of reported symptoms in this real-world cohort was often much greater than the prevalence of reported symptoms in clinical trials of similar treatment regimens.</p><p><strong>Conclusions: </strong>LLMs offer the ability to scale symptom extraction from health records, which is crucial to understand symptom burden and power symptom-related interventions and studies in real-world patient cohorts.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPP1+ macrophages polarized by lactate confer the progression of hypoxic adaptive tumor cells in brain.","authors":"Jianlei Zhang, Zhihui Li, Jiang Yin, Weina Fan, Hongfan Liao, Jing Dong, Xianfeng Yu, Yabing Cao, Qiong Zhang, Guopei Zheng, Qianming Yao","doi":"10.1093/neuonc/noaf208","DOIUrl":"https://doi.org/10.1093/neuonc/noaf208","url":null,"abstract":"<p><strong>Background: </strong>Brain malignancies originating from the central nervous system and metastasizing from extracerebral tumors remain incurable, while the underlying mechanisms remain unclear. In this study, we comprehensively investigated the pan-brain tumor microenvironment.</p><p><strong>Methods: </strong>We employed transgenic mice, stereotactic brain injections, flow cytometry, CRISPR/Cas9 gene editing, immunohistochemistry, immunofluorescence, quantitative reverse transcription-polymerase chain reaction, western blotting, co-immunoprecipitation, DNA pulldown assays, and chromatin immunoprecipitation.</p><p><strong>Results: </strong>We constructed single-cell RNA sequencing and spatial transcriptome profiles of pan-brain tumors and identified the enhanced hypoxia-inducible factor 1 (HIF-1) signaling in the intracerebral metastases compared with extracerebral parts, as well as in mesenchymal-subtype glioblastomas. Hypoxic adaptability mediated by HIF-1 signaling confers a tumor growth advantage in the brain. Integrated analysis and experimental models revealed the co-localization and mutual dependence between brain tumor hypoxic adaptability and macrophage infiltration. Hypoxic adaptive tumor cells recruit macrophages via galectin 1 (LGALS1) and induce differentiation toward the secreted phosphoprotein 1 (SPP1) + subpopulation via lactate mediated histone lactylation. SPP1 directly activates mitogen-activated protein kinase (MAPK) signaling in tumor cells to promote tumor growth and inhibits the cytotoxic activity of CD8+ T cells. Genetic SPP1 deficiency in macrophages delays hypoxic adaptive tumor growth in the brain and enhances the tumor response to anti-programmed cell death-1 (anti-PD-1) therapy. Preclinically, targeting lactate dehydrogenase A (LDHA) by stiripentol with blood-brain barrier permeability impedes brain tumor progression and synergizes with anti-PD-1 therapy.</p><p><strong>Conclusions: </strong>The interrelationship between hypoxic adaptive tumor cells and macrophages in the brain highlights the possibility of SPP1+ macrophage-based microenvironment remodeling in brain tumor therapy.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":""},"PeriodicalIF":13.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locoregional infusion of EGFR806-CAR T cells for recurrent or refractory pediatric CNS tumors: Results of the completed BrainChild02 phase 1 clinical trial.","authors":"Juliane Gust, Bonnie L Cole, Rebecca Ronsley, Ashley L Wilson, Kristy Seidel, Jason Wendler, Sowmya Pattabhi, Christopher Brown, Stephanie D Rawlings-Rhea, Nadezhda Shtanukhina, Samuel R Browd, Jason S Hauptman, Amy Lee, Jeffrey G Ojemann, Erin E Crotty, Sarah E S Leary, Francisco A Perez, Jason N Wright, Catherine M Albert, Navin Pinto, Rebecca A Gardner, Nicholas A Vitanza, Michael C Jensen, Julie R Park","doi":"10.1093/neuonc/noaf064","DOIUrl":"10.1093/neuonc/noaf064","url":null,"abstract":"<p><strong>Background: </strong>Relapsed/refractory pediatric central nervous system (CNS) tumors have a poor prognosis. Epidermal growth factor receptor (EGFR) is commonly overexpressed, but EGFRvIII mutations are uncommon. To target these tumors, we used chimeric antigen receptor (CAR) T cells with a binder based on mAb806 which recognizes ectopically expressed wild-type EGFR and EGFRvIII.</p><p><strong>Methods: </strong>In this open-label phase 1 clinical trial, patients aged 1-26 years with EGFR + CNS tumors received weekly infusions of 1-2.5 × 107 CAR T cells into the tumor resection bed or the lateral ventricle via an implanted catheter. No lymphodepletion was used.</p><p><strong>Results: </strong>Eleven patients were enrolled. Four (3 with high-grade glioma, 1 with atypical teratoid rhabdoid tumor) were treated and received 5-10 CAR T cell infusions without dose-limiting toxicities. The trial closed prior to reaching planned dose regimens. All treatment-related adverse events were no higher than CTCAE grade 2. The most common were headache and nausea. One patient had a grade 1 seizure, and 3 had new sensory changes, weakness and/or urinary changes (grades 1-2) that were possibly related to CAR T cell infusion. A total of 3 of the 4 treated patients had progressive disease. One patient with spinal cord diffuse midline glioma had progressive peritumoral edema that could not be conclusively attributed to either progression or pseudoprogression and was, therefore, defined as stable disease, followed by a complete response to subsequent chemotherapy.</p><p><strong>Conclusions: </strong>Intracranially infused EGFR806-CAR T cells were tolerable at tested doses, with the best response of stable disease. EGFR is a potentially useful target for cellular therapy against pediatric brain tumors, particularly high-grade gliomas.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":"2170-2181"},"PeriodicalIF":13.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The excitatory milieu in glioma: Mechanisms and therapeutic avenues.","authors":"Bobak F Khalili, Karan Dixit, David O Kamson, Craig Horbinski, Delilah J Przybyla, Matthew C Tate, Amy B Heimberger, Rimas V Lukas, Jessica W Templer","doi":"10.1093/neuonc/noaf063","DOIUrl":"10.1093/neuonc/noaf063","url":null,"abstract":"<p><p>Gliomas are the most common primary malignant brain tumors. Their electrobiologic properties drive disease development, and in select tumors, aberrant neurosignaling is situated at the crux of gliomagenesis and glioma-related epilepsy. Tumor microtubes and the neuronal-glioma synapse are defined components of the glioma circuitry. The nidus of cortical hyperexcitability-the peri-glioma-undergoes severe alterations during disease progression and is influenced by genetic mutations, anomalous synaptic remodeling, inflammatory changes, and an imbalance in neurotransmitters. Such pathologic mechanisms have been exploited for anticancer and anti-seizure value wherein a subset remains to be explored. In this Review, we discuss the hyperexcitable conditions within the glioma microenvironment and candidate therapies for seizure and tumor control.</p>","PeriodicalId":19377,"journal":{"name":"Neuro-oncology","volume":" ","pages":"1932-1945"},"PeriodicalIF":13.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}