Heterogeneity in Intra-Cranial Tumors: Diagnostic, Prognostic, and Therapeutic Implications

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Metastasis".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1244

Special Issue Editors


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Guest Editor
Department of Neuro-Oncology, Hospices Civils de Lyon, Bron, France
Interests: gliomas; glioblastoma stem cells; targeted therapies; tumor heterogeneity
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Guest Editor
Department of Neurological Surgery, University of California, San Francisco, CA, USA
Interests: cancer neurosciences; gliomas; functional network interactions; specific brain mapping strategies

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Guest Editor
Department of Neurosurgery, Hospices Civils de Lyon, Bron, France
Interests: fluorescence-guided surgery; gliomas; glioblastoma stem cells; tumor intrinsic connectivity; tumor heterogeneity

Special Issue Information

Dear Colleagues,

Recent advances have been made in diagnosing intra-cranial tumors, with a better definition of inter-tumoral heterogeneity. For instance, the WHO introduced a histo-molecular classification of gliomas in 2016, and new tumor entities, such as high-grade gliomas with piloid features, have been described. Additionally, there is also a high degree of intra-tumoral heterogeneity. Multiple tumor sampling and tumor resampling at progression have deciphered this heterogeneity at the spatial and temporal levels. From a functional viewpoint, the coexistence of areas characterized by different degrees of intrinsic connectivity has been demonstrated in gliomas. Moreover, single-cell analysis, notably applied to gliomas, has offered a better overview of inter- and intra-tumoral heterogeneity, identifying different transcriptomic signatures within the same tumor. This Special Issue aims to provide updated data regarding the inter- and intra-tumoral heterogeneity of intracranial neoplasms (gliomas, meningiomas, metastasis, etc.) and determine how this heterogeneity will influence therapeutic strategies and outcomes.

Prof. Dr. Francois Ducray
Dr. Shawn L. Hervey-Jumper
Dr. Thiebaud Picart
Guest Editors

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Keywords

  • glioma
  • histo-molecular classification
  • intra-tumoral heterogeneity
  • inter-tumoral heterogeneity
  • meningioma
  • neuro-oncology
  • neurosurgery

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Published Papers (1 paper)

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14 pages, 1141 KiB  
Systematic Review
Adult Cerebellopontine Angle Medulloblastoma: A Systematic Review of Clinical Features, Management Approaches, and Patient Outcomes
by Kishore Balasubramanian, Abdurrahman F. Kharbat, Francisco Call-Orellana, Sherwin A. Tavakol, Grace R. Fassina, Christopher Janssen, Othman Bin Alamer, Jeffrey A. Zuccato and Ian F. Dunn
Cancers 2024, 16(24), 4242; https://doi.org/10.3390/cancers16244242 - 20 Dec 2024
Cited by 1 | Viewed by 850
Abstract
Objective: The aim of this study was to systematically review the existing individual patient data in the literature on adult cerebellopontine angle (CPA) medulloblastoma (MB) and characterize the patient presentation, management strategies used, and oncological outcomes of this rare entity to guide future [...] Read more.
Objective: The aim of this study was to systematically review the existing individual patient data in the literature on adult cerebellopontine angle (CPA) medulloblastoma (MB) and characterize the patient presentation, management strategies used, and oncological outcomes of this rare entity to guide future clinical practice. Methods: Following PRISMA guidelines, a systematic review was conducted by searching PubMed, EMBASE, Web of Science, and Cochrane databases from inception to 19 June 2024. Studies regarding adult patients with histologically confirmed MB radiographically confirmed to be located in the CPA were included. Clinical data were synthesized, and predictors of outcomes were evaluated. Results: Twenty-seven studies with 42 adult CPAMB patients were included. The median age was 32 years (range: 19–56). Headaches (81%), cranial neuropathy (90%), cerebellar dysfunction (79%), and nausea/vomiting (50%) were typical presenting features. The predominant histological subtype was the classic variant. Maximal safe surgical resection was performed, most commonly using a retrosigmoid approach, and 60% of cases received a gross total resection. Most patients received adjuvant treatment (93%), typically chemoradiotherapy. The recurrence rate was 11% after a median of 18 months of follow-up. Relatively high survival rates of 96%, 85%, and 85% were observed at 1, 3, and 5 years, respectively. Patients who received adjuvant therapy had significantly better recurrence and greater overall survival outcomes. Conclusions: These results support the consideration of MB in young adult patients presenting with CPA tumors with radiographical features suggestive of hypercellularity and the utilization of a management strategy of maximal safe resection plus post-operative craniospinal irradiation along with chemotherapy to optimally treat these rare patients. Full article
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