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Immunotherapies against brain metastases have shown clinical benefits when applied to asymptomatic patients, but they are largely ineffective in symptomatic cases for unknown reasons. Here, we dissect the heterogeneity in metastasis-associated astrocytes using single-cell RNA sequencing and report a population that blocks the antitumoral activity of infiltrating T cells. This protumoral activity is mediated by the secretion of tissue inhibitor of metalloproteinase-1 (TIMP1) from a cluster of pSTAT3+ astrocytes that acts on CD63+ CD8+ T cells to modulate their function. Using genetic and pharmacologic approaches in mouse and human brain metastasis models, we demonstrate that combining immune checkpoint blockade antibodies with the inhibition of astrocyte-mediated local immunosuppression may benefit patients with symptomatic brain metastases. We further reveal that the presence of tissue inhibitor of metalloproteinase-1 in liquid biopsies provides a biomarker to select patients for this combined immunotherapy. Overall, our findings demonstrate an unexpected immunomodulatory role for astrocytes in brain metastases with clinical implications. Significance: This study presents a significant advancement in understanding immune modulation in brain tumors and offers new insights into the potential therapeutic interventions for brain metastases. See related commentary by Lorger and James, p. 11.
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http://dx.doi.org/10.1158/2159-8290.CD-24-0134 | DOI Listing |
PLoS One
September 2025
Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Background: Attention to existential needs has become part of daily treatment. Studies have described the concepts of existential experiences and existential interventions. However, a consensus or conceptual clarity regarding an existential approach in cancer patients is currently missing.
View Article and Find Full Text PDFJ Neurooncol
September 2025
Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Purpose: Breast cancer (BC) is the most frequent cancer among women and the second leading cause of central nervous system (CNS) metastases. While the epidemiology of CNS metastases from BC has been well described, little is known about the treatment patterns and outcomes of young women < 40 years of age with BC that is metastatic to the CNS.
Methods: In this retrospective analysis, we identified patients with metastatic breast cancer (MBC) to the CNS who were treated at the Sunnybrook Odette Cancer Center, Toronto, Canada between 2008 and 2018.
Neurosurg Rev
September 2025
Service de Neurochirurgie, GHU-Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, F-75014, France.
Awake craniotomy is the gold standard to achieve maximal safe resection of brain lesions located within eloquent areas. There are no established guidelines to assess patient's eligibility for awake craniotomy by weight class. This study assesses feasibility, safety, and efficacy of awake surgery by weight classes through an observational, retrospective, single-institution cohort analysis (2010-2024) of 526 awake craniotomies.
View Article and Find Full Text PDFNeurosurg Rev
September 2025
Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
Background: The aim of this review is to present the role of intraoperative flow cytometry (IFC) in the intracranial tumor surgery. This scoping review aims to summarize current evidence on the intraoperative use of IFC in patients with intracranial tumors.
Methods: A comprehensive literature search was conducted in the Medline, Cochrane and Scopus databases up to January 21, 2025.
JCI Insight
September 2025
The Arthur and Sonia Labatt Brain Tumor Research Center, The Hospital for Sick Children; Toronto, Canada.
More than a third of patients with glioblastoma experience tumor progression during adjuvant therapy. In this study, we performed a high-throughput drug repurposing screen of FDA-approved agents capable of crossing the blood-brain barrier in order to find agents to counteract acquired or inherent glioma cell resistance to temozolomide-associated cytotoxicity. We identified the cholesterol processing inhibitor, lomitapide, as a potential chemosensitizer in glioblastoma.
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