Advancements in Brain Tumor Therapy: The Impact of Microenvironment

Brain tumors pose significant treatment challenges due to their complex structure and the sensitive location within the brain. Surgical options are often limited by the brain's intricate layout, and systemic therapies are less effective due to the blood-tumor barrier (BTB) which is different from the standard blood-brain barrier (BBB). The surrounding environment of brain tumors includes a variety of cell types such as brain endothelial cells, astrocytes, neurons, and microglia, along with bone marrow-derived cells that migrate into the brain, which plays a critical role in tumor initiation, progression, immune evasion, and therapeutic resistance.

The goal of this Research Topic is to fully understand the tumor environment in brain cancers to develop new treatment strategies. By studying how different cells within the environment interact and affect tumor growth and resistance, we can identify potential targets for therapy. This understanding could lead to breakthroughs in treatment options which are currently limited and not very effective. In particular, we seek to understand how tumor–microenvironment interactions can be disrupted or modulated to enhance treatment efficacy.

This Research Topic welcomes contributions on the following topics:

•Comprehensive profiling of the diverse cellular make-up within the tumor environment.
•Investigating the roles of different brain and bone marrow-derived cells in tumor behavior.
•Extracellular vesicles and tumor communication. Role of exosomes and other extracellular vesicles in modulating the brain TME.
•Tumor vascularization and the BTB with emphasis in molecular differences between the BBB and BTB in gliomas.
•Neuroimmune interactions and immunotherapy.
•Hypoxia, acidosis, and metabolic reprogramming influences in tumor-microenvironment crosstalk.
•Techniques to better visualize and analyze the tumor environment. Development of non-invasive imaging biomarkers to assess TME dynamics. AI-assisted spatial analysis and radiomics for TME characterization.
•New treatment methods that target specific cells within the tumor environment.
•The application of new technologies (including nanomedicine approaches) in delivering drugs effectively to the brain.
•Novel approaches like nanoparticles, ultrasound, photothermal therapy and computational prediction models to cross/bypass the blood brain barrier.
•Clinical and translational insights. Correlation of TME signatures with patient prognosis and treatment response. Challenges and strategies in translating preclinical TME-targeting therapies to clinical trials.

By focusing on these areas, the research aims to pave the way for developing targeted therapies that are crucial for improving the management and outcomes of brain cancer patients.