Search Results (104)

Background/Objectives: Adult-type diffuse gliomas, including astrocytoma and glioblastoma multiforme (GBM), are brain tumors with a very poor prognosis. While current treatment options for glioma patients are not providing satisfactory outcomes, research indicates that natural compounds could serve as alternative treatments. However, their low bioavailability requires nanotechnology solutions, such as liposomes. Methods: In this study, we propose the co-encapsulation of acteoside (ACT) with other natural compounds, cannabidiol (CBD) or naringenin (NG), in a cationic liposomal nanoformulation consisting of DOTAP and POPC lipids, which were prepared using the dry lipid film method. The liposomes were characterized by their physicochemical properties, including particle size, zeta potential, and polydispersity index (PDI), with additional analyses performed using ¹H Nuclear Magnetic Resonance (NMR). Furthermore, biological experiments were performed with U-87 MG astrocytoma and U-138 MG GBM cell lines and non-cancerous MRC-5 lung fibroblasts using the MTT assay and evaluating the expression of Bax and Bcl-xL to evaluate their potential as anticancer agents. Conclusions: The IC₅₀ values for the nanoformulations in U-138 MG cells at 48 h were 6 µM for ACT + CBD and 5 µM for ACT + NG. ACT and CBD or NG demonstrated a potential synergistic effect against GBM in a liposomal formulation. Notably, treatment with ACT + CBD (5 µM) and ACT + NG (5 µM) liposomal formulations significantly upregulated Bax protein level in U-138 cells at both 24 and 48 h. In parallel, ACT + CBD (5 µM) also modulated Bcl-xL protein level in both U-138 MG and U-87 MG cell lines at the same time points. The obtained nanoformulations were homogeneous and stable for 21 days, evidenced by a narrow particle size distribution, a low polydispersity index (PDI) < 0.3, and a positive zeta potential. Full article

Intracranial tumors such as gliomas, meningiomas, and brain metastases induce complex alterations in brain function beyond their focal presence. Modern connectomic and neuroimaging approaches, including resting-state functional MRI (rs-fMRI) and diffusion MRI, have revealed that these tumors disrupt and reorganize large-scale brain networks in heterogeneous ways. In adult patients, diffuse gliomas infiltrate neural circuits, causing both local disconnections and widespread functional changes that often extend into structurally intact regions. Meningiomas and metastases, though typically well-circumscribed, can perturb networks via mass effect, edema, and diaschisis, sometimes provoking global “dysconnectivity” related to cognitive deficits. Therefore, this review synthesizes interdisciplinary evidence from neuroscience, oncology, and neuroimaging on how intracranial tumors disrupt functional brain connectivity pre- and post-surgery. We discuss how functional heterogeneity (i.e., differences in network involvement due to tumor type, location, and histo-molecular profile) manifests in connectomic analyses, from altered default mode and salience network activity to changes in structural–functional coupling. The clinical relevance of these network effects is examined, highlighting implications for pre-surgical planning, prognostication of neurocognitive outcomes, and post-operative recovery. Gliomas demonstrate remarkable functional plasticity, with network remodeling that may correlate with tumor genotype (e.g., IDH mutation), while meningioma-related edema and metastasis location modulate the extent of network disturbance. Finally, we explore future directions, including imaging-guided therapies and “network-aware” neurosurgical strategies that aim to preserve and restore brain connectivity. Understanding functional heterogeneity in brain tumors through a connectomic lens not only provides insights into the neuroscience of cancer but also informs more effective, personalized approaches to neuro-oncologic care. Full article

Gliomas are the most common and lethal malignant primary brain tumors in adults, associated with the highest number of years of potential life lost. The latest WHO classification for central nervous system tumors highlighted the need for new biomarkers of diagnosis, prognosis, and response to therapy. The PI3K/Akt signaling pathway is clearly implicated in tumorigenesis, being one of the most frequently altered pathways in cancer. Activating PI3KCA mutations are oncogenic and can influence both prognosis and treatment response in various tumor types. In gliomas, however, studies have reported inconsistent PIK3CA mutational frequencies, ranging from 0% to 30%. Furthermore, the impact of these alterations on glioma diagnosis, prognosis, and therapy response remains unclear. Current evidence suggests that PIK3CA mutations may represent early and constitutive events in glioma development, associated with worse glioblastoma prognoses, earlier recurrences, and widespread disease. Among these, the hotspot mutation H1047R has been particularly associated with a more aggressive phenotype while also modulating the neuronal microenvironment. In this review, we examine the clinical relevance of PIK3CA mutations across different cancers, with a particular focus on their emerging role in glioma. Moreover, we also discuss the therapeutic potential and challenges of targeting PIK3CA mutations in the context of glioma. Full article

Brain tumors, in particular gliomas and glioblastoma multiforme (GBM), are thought to originate from different cells facing specific founding insults, a feature that partly justifies the complexity and heterogeneity of these severe forms of cancer. However, gliomas and GBM are usually reproduced in animal models by inducing molecular alterations in mature glial cells, which, though being part of the puzzle, do not represent the whole picture. To fill this conceptual gap, we previously developed a neurogenic model of brain cancer in Drosophila, demonstrating that the loss of cell polarity in neural stem cells (called neuroblasts in the fruit fly) is sufficient to promote the formation of malignant masses that continue to grow in the adult, displaying several phenotypic traits typical of human GBM. Here, we expand on previous work by restricting polarity disruption to Drosophila type II neuroblasts, whose self-renewal is comparable to that of mammalian neural progenitors, with the aim to capture the molecular signature of the resulting cancers in a specific and reproducible context. A comparison of the most deregulated transcripts with those found in human primary GBMs confirmed that our model can be proficiently used to delve into the roots of human brain tumorigenesis. Full article

Central nervous system (CNS) tumors are the most common solid malignancy in the pediatric population. These lesions are the result of the aberrant cell signaling step proteins, which normally regulate cell proliferation. Mitogen-activated protein kinase (MAPK) pathways and tyrosine kinase receptors are involved in tumorigenesis of low-grade gliomas. High-grade gliomas may carry similar mutations, but loss of epigenetic control is the dominant molecular event; it can occur either due to histone mutations or inappropriate binding or unbinding of DNA on histones. Therefore, despite the absence of genetic alteration in the classic oncogenes or tumor suppressor genes, uncontrolled transcription results in tumorigenesis. Isocitric dehydrogenase (IDH) mutations do not predominate compared to their adult counterpart. Embryonic tumors include medulloblastomas, which bear mutations of transcription-regulating pathways, such as wingless-related integration sites or sonic hedgehog pathways. They may also relate to high expression of Myc family genes. Atypical teratoid rhabdoid tumors harbor alterations of molecules that contribute to ATP hydrolysis of chromatin. Embryonic tumors with multilayered rosettes are associated with microRNA mutations and impaired translation. Ependymomas exhibit great variability. As far as supratentorial lesions are concerned, the major events are mutations either of NFkB or Hippo pathways. Posterior fossa tumors are further divided into two types with different prognoses. Type A group is associated with mutations of DNA damage repair molecules. Lastly, germ cell tumors are a heterogeneous group. Among them, germinomas manifest KIT receptor mutations, a subgroup of the tyrosine kinase receptor family. Full article

Background/Objectives: The purpose of this study was to evaluate the performance of diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and diffusion microstructure imaging (DMI) in differentiating molecular subtypes of adult-type gliomas. Methods: Standardized MRI was performed and evaluated in 59 patients with adult-type glioma. DKI, NODDI, and DMI parameter values were quantitatively evaluated in ROIs in contrast-enhancing/solid tumor tissue and five concentric shells with peritumoral tissue. DKI, NODDI, and DMI parameters of (i) glioblastomas, Isocitrate dehydrogenase (IDH) wildtype; (ii) astrocytomas, IDH mutant; and (iii) oligodendrogliomas, IDH mutant were compared with analysis of variance (ANOVA). Receiver operating characteristic curve (ROC) curve analysis was conducted to discriminate firstly between IDH mutant and IDH wildtype gliomas and then between IDH mutant astrocytomas and oligodendrogliomas. Results: Significant differences between the three aforementioned subtypes were found for the apparent diffusion coefficient (ADC) and mean kurtosis (MK) and again for the orientation dispersion index (ODI) and intra-axonal volume fraction (v-intra). The diagnostic accuracy depended on the distance to the contrast-enhancing/solid tumor tissue. Some NODDI and DMI parameters significantly predicted the IDH status and significantly discriminated between astrocytomas and oligodendrogliomas; however, ADC and MK showed the best prediction in both ROC analyses (maximum AUC 0.910 (CI 0.824–0.995)). Conclusions: The evaluation of peritumoral tissue can be a valuable procedure, while NODDI and DMI appear to be promising but are currently inferior to DKI in predicting glioma subtypes categorized according to the WHO 2021 classification. Full article

Background/Objectives: The gene F3, encoding Tissue Factor (TF), is expressed in many cancers and contributes to their malignancy. Among adult-type diffuse gliomas, IDH1/2 wild-type (IDH^wt) glioblastomas (GBM) express more TF than IDH1/2 mutant (IDH^mut) gliomas. Tisotumab vedotin (TisVed), an anti-TF antibody conjugated to monomethyl auristatin E, is a therapeutic designed to target cells expressing TF. We therefore sought to determine the therapeutic potential of TisVed in IDH^wt vs. IDH^mut gliomas. Methods: We treated IDH^wt and IDH^mut patient-derived glioma cells with control IgG, unconjugated tisotumab (Tis), or TisVed in vitro, followed by cell viability assays and the assessment of TF signaling. We tested Tis and TisVed in mice intracranially engrafted with patient-derived IDH^wt and IDH^mut gliomas and mice flank engrafted with IDH^wt GBM. Results: TisVed was more active against cultured IDH^wt GBM cells than IDH^mut glioma cells. This activity was increased by the daily washout of soluble TF secreted by IDH^wt GBM cells. Unconjugated Tis had less effect than TisVed, and TF signaling was minimally inhibited. TisVed extended the survival of mice intracranially engrafted with IDH^wt GBM (p = 0.006), but not mice with IDH^mut glioma (p = 0.88). TisVed also reduced the growth of IDH^wt GBM flank xenografts. Tis alone had no antitumor effect in either setting. Notably, both TisVed and Tis were associated with hemorrhage in flank tumors. Conclusions: TisVed targets high-TF-expressing IDH^wt GBM, but not low-TF-expressing IDH^mut glioma. This is predominately through the vedotin conjugate rather than inhibition of TF signaling. Though the effect size is modest, TisVed shows anticancer effects against IDH^wt GBM. However, there could be complications related to hemostasis and hemorrhage. Full article

Background/Objectives: The non-invasive identification of glioma subtypes is useful for initial diagnosis, treatment planning, and follow-up. The aim of this study was to evaluate the performance of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced (DCE)-MRI in differentiating subtypes of adult-type diffuse gliomas. Methods: In a prospective multicenter study, standardized MRI was analyzed in 59 patients with adult-type diffuse glioma. DKI and DCE-MRI parameter values were quantitatively evaluated in ROIs of contrast-enhancing/solid tumor and four concentric shells of peritumoral tissue. The parameter means of glioblastomas, IDH wildtype; astrocytomas, IDH mutant; and oligodendrogliomas, IDH mutant were compared. Binary logistic regression analyses were performed to differentiate between IDH mutant and IDH wildtype gliomas and between IDH mutant astrocytomas and oligodendrogliomas. ROC curves were analyzed for each parameter and for combined regression. Results: Significant differences between the three aforementioned subtypes were found for the DKI and DCE-MRI parameters, depending on the distance to the tumor core. A combination of the parameters’ apparent diffusion coefficient (ADC) and fractional volume of extravascular extracellular space (ve) revealed the best prediction of IDH mutant vs. wildtype gliomas (AUC = 0.976 (0.943–1.000)) and astrocytomas vs. oligodendrogliomas (AUC = 0.840 (0.645–1.000)) with the lowest Akaike information criterion. Conclusions: The combined evaluation of DKI and DCE-MRI at different distances to the contrast-enhancing/solid tumor seems to be helpful in predicting glioma subtypes according to the WHO 2021 classification. Full article

Background: Isocitrate dehydrogenase (IDH) wild-type (wt) glioblastoma is an aggressive malignancy associated with poor clinical outcomes, marked by high heterogeneity and resistance to treatment. This study aims to investigate the prognostic significance of B7-H3 expression in IDH wt glioblastoma and its potential association with clinical outcomes, including overall survival (OS) and progression-free survival (PFS). Additionally, the relationship between B7-H3 and PD-L1 expression was explored. Methods: A retrospective cohort of 86 IDH wt glioblastoma patients, all of whom underwent surgery, radiotherapy, and temozolomide treatment, was analyzed. B7-H3 expression was quantified using an immunoreactivity score (IRS), classifying samples as low (IRS ≤ 4) or high (IRS > 4). PD-L1 expression was evaluated based on tumor and immune cell staining, with >5% positivity indicating significant expression. Results: High B7-H3 expression was significantly associated with poorer OS and PFS. Co-expression of B7-H3 and PD-L1 was prevalent, particularly among younger male patients with unifocal tumors; however, PD-L1 expression did not show a significant correlation with clinical outcomes. Conclusions: B7-H3 appears to be a promising prognostic biomarker in IDH wt glioblastoma and may serve as a target for developing combination therapies, integrating B7-H3-targeting treatments with immune checkpoint inhibitors. Further prospective studies are necessary to validate these findings and to explore potential therapeutic strategies. Full article

Background and Objectives: Primary central nervous system (CNS) tumors are often associated with relatively poor outcomes. Data on the epidemiology and outcome of CNS tumors in Jordan are scarce. We aim to report the epidemiology and outcome of primary CNS tumors of patients managed at a comprehensive cancer care center in Jordan. Methods: We performed a retrospective chart review of all Jordanian patients with a primary CNS tumor diagnosis who were managed at the center between July 2003 and June 2019. We included all entities described in the 2021 CNS WHO classification system, in addition to pituitary neuroendocrine tumors (PitNETs). We used the Kaplan–Meier method to estimate the 1-year, 2-year, and 5-year overall survival (OS) rates for each entity. Results and Findings: We included 2094 cases. The numbers of pediatrics and adults were 652 (31.1%) and 1442 (68.9%), respectively. The three most common groups of tumors were “gliomas, glioneuronal tumors, and neuronal tumors” (n = 1200 [57.30%]), followed by meningiomas (n = 261 [12.5%]), embryonal tumors (n = 234 [11.2%]). The three most common tumor families were adult-type diffuse gliomas (n = 709 [33.8%]), medulloblastoma (n = 199 [9.5%]), and circumscribed astrocytic gliomas (n = 183 [8.7%]). The median survival for the entire cohort was 97 months (95CI; 81–112). Survival was significantly worse for males and adults compared to their respective counterparts. Among the most common tumor group, “gliomas, glioneuronal tumors, and neuronal tumors”, OS rates for adult-type diffuse gliomas were significantly lower than all other types. Overall, adult gliomas with IDH-mutations had a survival advantage over wildtype cases (IDH-mutant 1-year OS, 89% [82–97%] vs. IDH-wildtype 1-year OS, 60% [52–70%]; p < 0.001). Conclusions: We present a detailed analysis of the primary CNS tumors diagnosed in the largest cancer center in Jordan between 2003 and 2019. We compared the epidemiology and overall survival of these patients to worldwide estimates and found the epidemiology and outcome of these tumors comparable to worldwide trends. Full article

Background: It is unclear as to where we stand with respect to utilizing emerging focused ultrasound (FUS) technology in the setting of brain tumor treatment in pediatric patients, such as malignant diffuse intrinsic pontine glioma, and various adult counterparts. Correspondingly, the aim of this study was to present a contemporary summary of all pertinent clinical trials to date. Methods: The ClinicalTrials.gov database was reviewed in January 2025 for all possible clinical trials involving FUS in the management of brain tumors. These were then screened against selection criteria to identify pertinent clinical trials. Results: A total of 30 clinical trials were identified. The majority were focused on adult patients (24/30, 80%), with the most common tumor type being glioblastoma (GBM) (14/30, 47%). There were also trials focused on pediatric patients only (5/30, 17%), as well as diffuse intrinsic pontine glioma (DIPG) (5/30, 17%). The most prevalent primary outcome of interest was safety (26/30, 87%). The majority of trials were active, either recruiting currently (12/30, 40%), or active but not recruiting currently (3/30, 10%). North America (22/30, 73%) was the most common location for the primary coordinating institution, and the median number of institutions per trial was one. The median expected start year for all trials was 2021, and the completion year was 2024. To date, there have been no results (interim or final) formally reported, although preliminary reports in the literature indicate this to be a safe procedure. Anecdotal trends suggest later trials target the blood-brain barrier more, involve more pediatric patients, and are more based in the United States. Conclusion: There exists a number of early-stage clinical trials investigating FUS to treat a variety of brain tumors in pediatric patients, as well as adult patients, with a significant clinical potential to improve outcomes. To date, no official results have been published, however anecdotal evidence is promising, and a number of results are expected soon. Full article

Adult-type diffuse gliomas are characterized by inevitable recurrence and very poor prognosis. Novel treatment options, including multimodal drugs or effective drug combinations, are therefore eagerly awaited. Tinostamustine is an alkylating and histone deacetylase inhibiting molecule with great potential in cancer treatment. Thus, the aim of this study was to investigate its effects on glioma cells. In this context, tinostamustine was evaluated in monotherapy and as a combination therapy, with either celecoxib or temozolomide; additionally, the results were compared to the golden glioma chemotherapy standard—temozolomide. Our experiments, conducted on both temozolomide-sensitive U-87 MG astrocytoma and temozolomide-resistant U-138 MG glioblastoma cells revealed that tinostamustine and its combination with either celecoxib or temozolomide exert dose-dependent cytotoxicity, cause cell cycle arrest, induce oxidative stress-mediated apoptosis of malignant glioma cells, and mitigate their migratory potential. Astrocytoma cells were more susceptible to the tested treatments than glioblastoma cells, and, generally, those dual therapies were superior in anti-glioma efficacy compared to temozolomide. Overall, our study provides evidence that tinostamustine and the combination therapies consisting of tinostamustine and celecoxib or tinostamustine and temozolomide may represent a new approach for the effective treatment of malignant gliomas. Full article

Background/Objectives: Physicians face clinical dilemmas in the diagnosis of non-optic intraparenchymal lesions on MRI brain scans of patients with neurofibromatosis type 1. As the incidence and evolution of these lesions into adulthood remain unclear, we conducted a retrospective study on this topic. Methods: All adult neurofibromatosis type 1 patients who had at least one MRI brain scan in our center were selected for this study. Brain lesions with contrast enhancement after gadolinium administration and/or mass effect were named “glioma-like lesions”. Results: In our cohort of 396 adult neurofibromatosis type 1 patients, 182 had at least one MRI scan of the brain. A total of 48 glioma-like lesions were found in 38/182 patients. The majority of glioma-like lesions remained stable, decreased in size or even disappeared during a median follow-up time of 8.5 years. Twelve glioma-like lesions in 11/182 patients were resected or biopsied, and histology showed gliomas of astrocytic origin (WHO grade 1–4). Conclusions: It was concluded from these data that asymptomatic glioma-like lesions on MRI brain scans in neurofibromatosis type 1 patients, either with contrast enhancement and/or mass effect, had an indolent nature. Mildly symptomatic or asymptomatic patients can therefore be followed without invasive diagnostic and therapeutic procedures. Full article

The latest World Health Organization (WHO) classification of central nervous system tumors (WHO2021/5th) has incorporated molecular information into the diagnosis of each brain tumor type including diffuse glioma. Therefore, an artificial intelligence (AI) framework for learning histological patterns and predicting important genetic events would be useful for future studies and applications. Using the concept of multiple-instance learning, we developed an AI framework named GLioma Image-level and Slide-level gene Predictor (GLISP) to predict nine genetic abnormalities in hematoxylin and eosin sections: IDH1/2, ATRX, TP53 mutations, TERT promoter mutations, CDKN2A/B homozygous deletion (CHD), EGFR amplification (EGFRamp), 7 gain/10 loss (7+/10−), 1p/19q co-deletion, and MGMT promoter methylation. GLISP consists of a pair of patch-level GLISP-P and patient-level GLISP-W models, each pair of which is for a genetic prediction task, providing flexibility in clinical utility. In this study, the Cancer Genome Atlas whole-slide images (WSIs) were used to train the model. A total of 108 WSIs from the Tokyo Women’s Medical University were used as the external dataset. In cross-validation, GLISP yielded patch-level/case-level predictions with top performances in IDH1/2 and 1p/19q co-deletion with average areas under the curve (AUCs) of receiver operating characteristics of 0.75/0.79 and 0.73/0.80, respectively. In external validation, the patch-level/case-level AUCs of IDH1/2 and 1p/19q co-deletion detection were 0.76/0.83 and 0.78/0.88, respectively. The accuracy in diagnosing IDH-mutant astrocytoma, oligodendroglioma, and IDH-wild-type glioblastoma was 0.66, surpassing the human pathologist average of 0.62 (0.54–0.67). In conclusion, GLISP is a two-stage AI framework for histology-based prediction of genetic events in adult gliomas, which is helpful in providing essential information for WHO 2021 molecular diagnoses. Full article

Background/Objectives: Glioblastoma (GBM) is the most aggressive type of brain tumor in adults. Currently, the only treatments available are surgery, radiotherapy, and chemotherapy based on temozolomide (TMZ); however, the prognosis is dismal. Several natural substances are under investigation for cancer treatment. 8α-O-(3,4-dihydroxy-2-methylenebutanoyloxy) dehydromelitensine (Isocnicin) is a natural compound derived from Centaurea species and was found to exhibit cytostatic/cytotoxic effect against different cell lines. In this study, we investigated the anti-glioma effects of isocnicin in U87 and T98 glioblastoma cell lines, as well as the effects of combined treatment with radiotherapy. Methods: Cell viability was evaluated with the trypan blue exclusion assay, cell cycle distribution was examined using flow cytometry, and the effects of the combination treatment were analyzed with CompuSyn software(1.0). Results: The result showed that isocnicin significantly reduced cell viability in U87 and T98 cell lines in a dose-dependent manner and IC₅₀ values were calculated. Administration of isocnicin alone induced both S and G2/M cell cycle arrest in U87 and T98 cells in a dose-dependent manner. Moreover, when cells were treated with increasing concentrations of isocnicin, followed by 2 or 4 Gy of radiation, the percentage distribution of the cells in the G2/M phase was increased considerably in both U87 and T98 cell lines. Conclusions: Here, we show for the first time that co-treatment of isocnicin with radiation exerts a synergistic antiproliferative effect in glioblastoma cell lines. Natural compounds are promising for glioblastoma treatment. Further studies will be necessary to unravel isocnicin’s mechanism of action and its synergistic effect with radiation on glioblastoma treatment. Full article