Solid tumors: latest on treaments and research pathways

The meta-analysis evaluates the impact of pituitary stalk preservation during craniopharyngioma surgery on pituitary function, resection extent, and recurrence. Preservation reduces diabetes insipidus risk but may increase incomplete resection risk in pediatric patients. Results are cautious due to small study sizes and reporting biases.

A UCL-sponsored clinical trial for patients newly diagnosed with glioblastoma, an aggressive form of brain cancer, has opened at UCLH's National Hospital for Neurology and Neurosurgery and Clinical Research Facility, in memory of Baroness Margaret McDonagh. Led by Dr. Paul Mulholland from UCL Cancer Institute and consultant medical oncologist at UCLH, the Win-Glio trial will recruit 16 patients over an 18-month period.

The team used techniques called single-cell sequencing and spatial transcriptomics to study the regulation of infiltrating glioblastoma cells. By analyzing which genes were active, chemical modifications to the DNA, how open or closed different regions of DNA were, and how tumour cells physically and molecularly interacted with nearby neurons, they identified key developmental pathways that invasive glioblastoma cells hijack to spread through the brain.
One such pathway is called NOTCH signaling – a cell communication system used by multicellular organisms to control cell fate decisions, such as differentiation, proliferation and apoptosis. The tumour cells hijack this pathway to activate oligodendrocyte lineage programs, effectively masquerading as normal OPCs.
The findings suggest that targeting this pathway and the regulatory programs involved may help limit tumour spread.

Despite no visible tumor growth, new research finds that the artificial sweetener aspartame reshapes gut bacteria and upregulates cancer-linked genes in glioblastoma.

Results indicated a statistically significant prolongation of progression-free survival among vaccinated patients, with a hazard ratio of 0.64 (p < 0.001). This suggests that vaccination therapies can reduce the risk of tumor progression by approximately 36% compared to controls. More intriguingly, a modest but highly significant improvement in overall survival was noted, with an HR of 1.09 (p < 0.00001). While the absolute survival benefit observed might appear modest, even incremental gains in glioblastoma are clinically meaningful, given the disease’s aggressive course and grim median survival times.

In a groundbreaking study poised to redefine our understanding of glioblastoma biology, researchers have uncovered a paradoxical role of Gasdermin E (GSDME) in this aggressive brain cancer. Traditionally recognized as a crucial mediator of pyroptosis—a highly inflammatory and lytic form of programmed cell death—GSDME has now been found to contribute to glioblastoma’s notorious resistance to pyroptosis, simultaneously promoting tumor progression. This unexpected duality challenges existing paradigms around cell death pathways in cancer and opens novel avenues for therapeutic intervention.

The study finds that using Tumor Treating Fields therapy (TTFields), which delivers targeted waves of electric fields directly into tumors to stop their growth and signal the body's immune system to attack cancerous tumor cells, may extend survival among patients with glioblastoma, when combined with immunotherapy (pembrolizumab) and chemotherapy (temozolomide).

This systematic review and meta-analysis examined the impact of pituitary stalk sacrifice during craniopharyngioma surgery. It found that sacrificing the stalk significantly increases the risk of postoperative endocrine dysfunction without reducing tumor recurrence or progression, highlighting the importance of preserving the stalk when possible.

CAR-T activity is still modest in GBM, and there are multiple limitations to its use in this setting, said Elena Garralda, MD, PhD, of Vall d'Hebron Institute of Oncology in Barcelona, who served as ASCO session study discussant.

Characterization of GBM cells has contributed to identify several molecules as targets for immunotherapy-based treatments such as EGFR/EGFRvIII, IL13Rα2, B7-H3, and CSPG4. Cytotoxic T lymphocytes collected from a patient can be genetically modified to express a chimeric antigen receptor (CAR) specific for an identified tumor antigen (TA). These CAR T cells can then be re-administered to the patient to identify and eliminate cancer cells. The impressive clinical responses to TA-specific CAR T cell-based therapies in patients with hematological malignancies have generated a lot of interest in the application of this strategy with solid tumors including GBM.

In a study published in May in Cell Death and Disease, researchers identified a previously unknown trait of cancer cells that shows promise for therapeutic intervention. The group outlined the mechanism of action and effectiveness of the experimental drug known as JM2, revealing its potential as a peptide therapy to target cancer cells that can renew and regrow, even after chemotherapy and radiation.

In the relentless fight against glioblastoma, the most common and lethal form of primary brain cancer, new research is shedding light on a previously hidden collaborator within the tumor microenvironment—astrocytes. These star-shaped glial cells, traditionally known for their supportive roles in the central nervous system, have now been implicated in actively orchestrating immune evasion strategies that allow glioblastomas to thrive despite aggressive treatments. Groundbreaking work led by Faust Akl and colleagues unravels a complex molecular dialogue where tumor-derived signals reprogram astrocytes into suppressors of anti-tumor immunity, revealing promising therapeutic avenues that could reshape glioblastoma treatment paradigms.

Our study investigated the role of astrocytes, an abundant cell type in the brain, in regulating an immune response against glioblastoma (GBM)-a highly aggressive brain cancer. We found a subset of astrocytes that limits the immune response and can be targeted with therapeutics.

In a groundbreaking study poised to shift the paradigm of glioblastoma treatment, researchers have unveiled compelling evidence that gabapentinoids, a class of drugs traditionally employed in neuropathic pain and seizure management, confer a significant survival advantage in human glioblastoma patients. This revelation arises from an extensive, multifaceted investigation that meticulously combines clinical data, molecular biology, and pharmacological insights, potentially opening new therapeutic avenues for one of the deadliest brain cancers known to medicine.

In the relentless battle against gliomas, a notoriously aggressive and often deadly form of brain cancer, the quest for effective immunotherapy targets remains a paramount scientific challenge. Gliomas’ ability to evade immune detection has historically hindered the development of T-cell mediated therapies, largely due to the scarcity of identified tumor-specific antigens that effectively trigger immune responses. However, an innovative study is poised to change this narrative by unveiling a new reservoir of potential immunogenic targets derived from the aberrant transcriptomic landscape of glioma cells. This breakthrough work not only broadens our understanding of tumor antigenicity but also illuminates a promising avenue toward personalized immunotherapies.

The phase 2B SURVIVE trial testing SurVaxM, a cancer vaccine for glioblastoma, will continue as planned following an interim analysis showing sufficient promise to proceed. SurVaxM, combined with standard treatments like surgery, radiation, and chemotherapy, aims to extend survival and improve quality of life for patients with this aggressive brain cancer.
The vaccine targets survivin, a protein that helps tumor cells evade death, and has shown a strong safety profile and encouraging survival rates in earlier studies. While specific results remain confidential due to trial regulations, the decision to continue marks a hopeful step in the development of more effective glioblastoma therapies.

In a groundbreaking advancement that promises to reshape the landscape of glioblastoma research and treatment, a team of researchers led by Yu, Basu, Baquer, and their colleagues have unveiled a novel investigative approach utilizing needle core biopsies to enable comprehensive multimodal deep-data generation. 

GSK is licensing an ABL Bio technology that yields bispecific antibodies engineered to leverage a certain transmembrane receptor to cross the blood-brain barrier to treat neurodegeneration. GSK is already partnered with Alector, which has monoclonal antibodies in clinical development for Alzheimer’s disease.

In a Phase I clinical trial reported in Nature Communications, two researchers from UT Southwestern and their colleagues showed this strategy was safe and effective. The team worked with 21 patients at medical centers, including UTSW, who had recurrent glioblastoma. They were divided into six groups, each of which received a different dose of radiation-emitting nanoparticles through CED. Patients who received the highest doses had tolerable side effects and lived an average of 17 more months after treatment, significantly longer than expected for patients with recurrent glioblastoma. The authors suggest this strategy shows promise for improving treatments for these patients.

As recently reported in Neuro-Oncology, a team led by John Liu at the University of California, San Francisco Brain Tumor Center has developed a CRISPR–Cas9-based epigenetic editing approach that sensitizes glioblastoma cells to standard chemotherapy drugs. This technology could improve the treatment of tumours that have developed resistance to these drugs.

Researchers are continuously on the lookout for innovative treatment strategies for glioblastoma, a notoriously aggressive brain cancer. Recently, an exciting preclinical study published in the esteemed journal Oncotarget explored the combination of imipridones—specifically, ONC201 and its analog ONC206—with traditional therapies like radiation (RT) and temozolomide (TMZ). The research team, led by Brown University’s Lanlan Zhou under the guidance of Wafik S. El-Deiry, focuses on a revolutionary treatment regimen termed IRT—imipridones, radiation, and temozolomide. This therapy has demonstrated a potential breakthrough in reducing tumor burden and prolonging survival in an orthotopic IDH-WT glioblastoma mouse model.

A new research paper was published in Oncotarget, Volume 16, on March 27, 2025, titled "Imipridones ONC201/ONC206 + RT/TMZ triple (IRT) therapy reduces intracranial tumor burden, prolongs survival in orthotopic IDH-WT GBM mouse model, and suppresses MGMT."

Using the proliferation–diffusion model to classify tumors, we identified moderately diffuse tumors with methylated MGMT status as a subgroup with significant survival benefits from SUPR. Our findings also emphasize the need for standardized definitions of tumor invasiveness cutoffs and the limitations of current imaging modalities in accurately estimating tumor cell density.

Glioblastoma (GBM) is a difficult disease to treat for different reasons, with the blood–brain barrier (BBB) preventing therapeutic drugs from reaching the tumor being one major hurdle. The median overall survival is only 14.6 months after the standard first line of treatment. At relapse, there is no recognized standard second-line treatment. Our team uses intra-arterial (IA) chemotherapy as a means to bypass the BBB, hence achieving an overall median survival of 25 months.