Dissemination of Glioblastoma Multiforme Outside Brain Is Common

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The finding of extracranial metastases after organ transplantation from glioblastoma multiforme donors raised issues with the notion that disease spread is restricted to the brain. In a study reported in Science Translational Medicine, Müller and colleagues found that hematogenous spread of glioblastoma multiforme is a common feature of the disease.

Immunostaining of enriched mononuclear cells with antibodies directed against glial fibrillary acidic protein identified glioblastoma multiforme circulating tumor cells in peripheral blood in 29 (21%) of 141 glioblastoma patients. Surgical intervention did not appear to markedly enhance tumor cell dissemination.

The absence of glial fibrillary acidic protein-positive cells in healthy volunteers and the presence of such tumor-specific alterations as EGFR amplification and gains and losses in genomic regions of chromosomes 7 and 10 in the patient samples support the identification of glioblastoma multiforme tumor as the source of the circulating cells. The spread of the cells was associated with EGFR amplification, indicating that the cells have growth potential.

The investigators concluded, “We demonstrate that hematogenous [glioblastoma multiforme] spread is an intrinsic feature of [glioblastoma multiforme] biology.” ■

Müller C, et al: Sci Transl Med 247:247ra101, 2014.