Glioblastoma cancer stem cells

Abstract

Many types of cancer, including Glioblastoma (GBM), contain functionally subsets of cells with stem-like properties named cancer stem cells (CSCs). These are characterized by chemotherapy resistance and considered one of the key determinants driving tumor relapse. Many studies demonstrated that glioma stem cells (GSCs) reside in particular tumor niches that are necessary to support their behaviour. Indeed, the microenvironment is essential for GBM tumorigenesis and progression, particularly for the continuous signal communications between GSCs and cells belonging to the GBM niches, like endothelium or pericytes, which give rise to a complex plasticity of the tumor. This signal integration originates numerous mechanisms which lead to resistance to therapy. Understanding the mechanism of action of the microenvironmental signals and the interplay between different cell types within the tumor mass, open new questions on how GSCs modulate GBM aggressiveness and response to therapy. The definition of these tumor features will allow to setup innovative multimodal therapies able to target GBM cells at multiple levels. In this chapter, we will discuss the major advances in the study of GSCs role in GBM and the therapeutic implications resulting from them, thus reporting the development of new targeted-therapies applied to counteract and overcome GBM intrinsic resistance to therapy which could improve the overall therapeutic ratio of conventional treatments.