Glioblastomas (GBM) are aggressive and therapy-resistant brain tumours, which contain a subpopulation of tumour-propagating glioblastoma stem-like cells (GSC) thought to drive progression and recurrence. Diffuse invasion of the brain parenchyma, including along preexisting blood vessels, is a leading cause of therapeutic resistance, but the mechanisms remain unclear. Here, we show that ephrin-B2 mediates GSC perivascular invasion. Intravital imaging, coupled with mechanistic studies in murine GBM models and patient-derived GSC, revealed that endothelial ephrin-B2 compartmentalises non-tumourigenic cells. In contrast, upregulation of the same ephrin-B2 ligand in GSC enabled perivascular migration through homotypic forward signalling. Surprisingly, ephrin-B2 reverse signalling also promoted tumourigenesis cell-autonomously, by mediating anchorage-independent cytokinesis via RhoA. In human GSC-derived orthotopic xenografts, EFNB2 knock-down blocked tumour initiation and treatment of established tumours with ephrin-B2-blocking antibodies suppressed progression. Thus, our results indicate that targeting ephrin-B2 may be an effective strategy for the simultaneous inhibition of invasion and proliferation in GBM.Glioblastoma is the most common and deadly type of brain cancer. On average, patients with glioblastoma only survive 15 months even with aggressive treatment. One of the main reasons that therapy fails is the strong tendency of the tumor cells in this form of cancer to spread into the normal brain tissue. This makes it impossible for surgeons to completely remove the tumor, which means that the disease will almost always recur.Within the brain, invading glioblastoma tumor cells spread along pre-existing structures, like blood vessels. When the tumors use blood vessels as a highway to the rest of the brain it is called “perivascular invasion”. Scientists do not know exactly how glioblastoma cells move along the blood vessels. Learning more about this type of tumor cell movement could help scientists develop treatments to stop the tumor cells from spreading.Now, Krusche et al. show that the glioblastoma tumor cells highjack the system that normally helps keep brain cells in place. Experiments with mouse and human tumor cells grown in the laboratory and injected in mice to produce glioblastoma tumors showed that a family of proteins called ephrins determines whether perivascular invasion occurs. Ephrins are found on the surface of both tumor cells and blood vessels. Normally, the blood vessels use these proteins to block the spread of normal brain cells. However, tumor cells override this normal anti-tumor mechanism and become able to spread along the blood vessels.Specifically, Krusche et al. showed that an increase in the levels of ephrin-B2 in tumor cells allows them to move along the blood vessels. Ephrin-B2 was also found to drive the multiplication of the tumor cells independently of the protein’s interactions with the blood vessels. Using antibodies to block ephrin-B2 in tumors greatly reduced tumor size and extended survival in mice with glioblastoma tumors. The experiments suggest the blocking ephrin-B2 might be a therapy that both stops the glioblastoma cells from spreading and prevents the tumor cells from multiplying.
Krusche, B., Ottone, C., Clements, M. P., Johnstone, E. R., Goetsch, K., Lieven, H., … Parrinello, S. (2016). EphrinB2 drives perivascular invasion and proliferation of glioblastoma stem-like cells. ELife, 5. https://doi.org/10.7554/elife.14845