Cancer Stem Cells in Glioblastoma Multiforme

Authors: Amy Bradshaw, Agadha Wickremesekera, Helen D. Brasch, Alice M. Chibnall, Paul F. Davis, Swee T. Tan and Tinte Itinteang

Frontiers in Surgery – Neurosurgery, Front Surg 2016;3:48

Glioblastoma multiforme (GBM) is the most aggressive type of primary brain tumour. It has a five-year survival of only 2%, despite intensive research. It frequently recurs following surgical resection, radiotherapy and chemotherapy. This poor prognosis has been attributed to the initiation, propagation and differentiation of cancer stem cells (CSCs).

The CSCs concept proposes that a cancer originates from a small population of CSCs, either by the acquisition of mutations in normal embryonic stem cells (ESCs) in this tissue, or progenitor cells that have the ability for uncontrolled growth and propagation. While the CSCs are postulated to be the driving force behind the growth of the cancer, the bulk of the tumour consists of cancer cells that have differentiated from these CSCs but do not have the ability to generate new cancer cells.

CSCs in GBM express characteristic proteins, making it possible to both characterise and isolate CSCs. Some of these play a greater role in maintaining stem cell capabilities. Five of them were investigated and all were identified in GBM. While one of them was ubiquitous, another was in quite low levels. This might suggest a hierarchy of stem cells within GBM.