A review of the role of stem cells in the development and treatment of glioma

• Published in: Acta neurochirurgica Vol. 154; no. 6; pp. 951 - 969
• Main Authors: Heywood, Richard M., Marcus, Hani J., Ryan, David J., Piccirillo, Sara G. M., Al-Mayhani, Talal M. Fael, Watts, Colin
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.06.2012; Springer Nature B.V
• Subjects: Animals; Brain Neoplasms - etiology; Brain Neoplasms - pathology; Brain Neoplasms - therapy; Brain tumors; Cell Differentiation - physiology; Cell Transformation, Neoplastic - genetics; Cell Transformation, Neoplastic - pathology; Drug delivery; Glioma; Glioma - etiology; Glioma - physiopathology; Glioma - therapy; Glioma cells; Humans; Interventional Radiology; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Neoplastic Stem Cells - pathology; Neurology; Neuronal-glial interactions; Neuroradiology; Neurosurgery; Review Article; Reviews; Stem Cell Transplantation - methods; Stem Cell Transplantation - trends; Stem cells; Surgical Orthopedics; Glioma; Cancer stem cells; Glioblastoma multiforme; Stem cells
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-012-1338-9

The neurosurgical management of patients with intrinsic glial cancers is one of the most rapidly evolving areas of practice. This has been fuelled by advances in surgical technique not only in cytoreduction but also in drug delivery. Further innovation will depend on a deeper understanding of the biology of the disease and an appreciation of the limitations of current knowledge. Here we review the controversial topic of cancer stem cells applied to glioma to provide neurosurgeons with a working overview. It is now recognised that the adult human brain contains regionally specified cell populations capable of self-renewal that may contribute to tumour growth and maintenance following accumulated mutational change. Tumour cells adapted to maintain growth demonstrate some stem-like characteristics and as such constitute a legitimate therapeutic target. Cellular reprogramming technologies raise the potential of developing stem cells as novel surgical tools to target disease and possibly ameliorate some of the consequences of treatment. Achieving these goals remains a significant challenge to neurosurgical oncologists, not least in challenging how we think about treating brain cancer. This review will briefly examine our understanding of adult stem cells within the brain, the evidence that they contribute to the development of brain tumours as tumour-initiating cells, and the potential implications for therapy. It will also look at the role stem cells may play in the future management of glioma.