ABSTRACT
Introduction
Malignant primary and secondary brain tumors pose a major health challenge, and the incidence of these tumors is rising. The brain tumor microenvironment (TME) is highly complex and thought to impact treatment resistance and failure. To enable a greater understanding of the milieu of cells in the brain TME, advances in imaging and sequential profiling of proteins/mRNA have given rise to the field of spatial transcriptomics. These technologies provide a greater depth of understanding of the tissue architecture, cellular and spatial profiles, including cellular activation status, which may provide insights into effective therapies for brain cancers.
Areas Covered
In this review, we provide an overview of spatial profiling technologies at the forefront in the field and describe the applications for brain cancer.
Expert opinion
Brain tumors are often resistant to treatment, and display both an immunosuppressive and heterogeneous tumor microenvironment. Next-generation imaging and multi-omics technologies are providing a tool for intricately characterizing their tissue biology. This information will aid in the design of effective therapies and begin to provide an understanding of therapy resistance.
Declaration of interest
P Kalita-de Croft is supported by the Australian National Health and Medical Research Council (APP1017028). K O’Byrne is supported by the Princess Alexandra Hospital Foundation grant. SR Lakhani is supported by the Australian National Health and Medical Research Council (APP1017028). A Kulasinghe is funded by NHMRC ECF fellowship (APP1157741) and Cure Cancer (APP1182179). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Reviewer Disclosures
Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.
Article Highlights
•The incidence rate of primary and secondary malignant brain cancers has increased globally by 17.3% in the last 25 years.
•Magnetic Resonance Imaging (MRI) remains the gold standard diagnostic tool for brain cancer.
•The current standard therapies are surgery, radiotherapy and systemic treatments (e.g., targeted agents, cytotoxic chemotherapy, and immunotherapy)
•There is an unmet need for more effective therapies in brain cancer
•The unique biology of the brain tumor microenvironment leads to primary and secondary resistance to treatment
•Malignant brain tumors display extensive intra-tumor heterogeneity
•Recent tissue profiling advancements may provide a rationale for intra-tumor heterogeneity
•Spatial profiling technologies have proven to be a game changer for multiple cancers to understand the cell–cell interactions
•Spatial profiling technologies have been used to identify predictive biomarkers of response to therapy