Abstract
The mechanisms governing therapeutic resistance of the most aggressive and lethal primary brain tumor in adults, glioblastoma, have increasingly focused on tumor stem cells. These cells, protected by the periarteriolar hypoxic GSC niche, contribute to the poor efficacy of standard of care treatment of glioblastoma. Integrated proteogenomic and metabolomic analyses of glioblastoma tissues and single cells have revealed insights into the complex heterogeneity of glioblastoma and stromal cells, comprising its tumor microenvironment (TME). An additional factor, which isdriving poor therapy response is the distinct genetic drivers in each patient’s tumor, providing the rationale for a more individualized or personalized approach to treatment. We recently reported that the G protein-coupled receptor CCR5, which contributes to stem cell expansion in other cancers, is overexpressed in glioblastoma cells. Overexpression of the CCR5 ligand CCL5 (RANTES) in glioblastoma completes a potential autocrine activation loop to promote tumor proliferation and invasion. CCL5 was not expressed in glioblastoma stem cells, suggesting a need for paracrine activation of CCR5 signaling by the stromal cells. TME-associated immune cells, such as resident microglia, infiltrating macrophages, T cells, and mesenchymal stem cells, possibly release CCR5 ligands, providing heterologous signaling between stromal and glioblastoma stem cells. Herein, we review current therapies for glioblastoma, the role of CCR5 in other cancers, and the potential role for CCR5 inhibitors in the treatment of glioblastoma.
Highlights
The most aggressive and common primary brain tumor in adults, glioblastoma (GBM), is poorly responsive to therapy, including surgery followed by chemotherapy and radiation, and has one of the shortest (5 years) patient survival rates (
The challenge to improving survival in GBM include the presence of glioblastoma stem cells that both resist irradiation and chemotherapeutics and evade immune cell-killing mechanisms by altering their genotype via endogenous genomic plasticity
Rather than targeting the stromal cells in the glioblastoma environment, we believe that inhibiting cross talk within the GBM tumor microenvironment (TME) may be a more efficient way to disable tumor proliferation
Summary
The most aggressive and common primary brain tumor in adults, glioblastoma (GBM), is poorly responsive to therapy, including surgery followed by chemotherapy and radiation, and has one of the shortest (5 years) patient survival rates (
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