Release the ballast: Glioblastoma rises above radiation therapy by exporting miR-603 in extracellular vesicles to become treatment-resistant

摘要

Glioblastoma (GBM) remains an incurable disease with a mediansurvival of ~15-18 months post-diagnosis, despite ongoing efforts toimprove treatment outcome [1]. Standard-of-care consists of maximumsafe surgical resection followed by systemic temozolomide (TMZ) andlocal radiation. After initial treatment with this regimen, GBM universally recurs and subsequent lines of therapy have limited efficacy. As aresult, there is a great need to understand the biology of acquired therapeutic resistance in this disease. One mechanism that has been proposed to confer GBM treatment unresponsiveness and recurrence isenrichment of cancer stem cells (CSCs), a population that is resistant tostandard-of-care therapies and has the capacity to give rise to therecurrent tumor. In this issue, Ramakrishnan et al. report that GBMacquires a treatment-resistant CSC phenotype following radiation therapy by actively exporting miR-603 in extracellular vesicles (EV) [2].