The neuroscience of brain cancers

In the central nervous system (CNS), where neuronal activity promotes brain development and plasticity, including glial precursor cell proliferation, the activity of neurons robustly drives the initiation, growth, invasion, treatment resistance, and progression of brain cancers such as adult and pediatric hemispheric high-grade gliomas, diffuse midline gliomas such as diffuse intrinsic pontine glioma (DIPG), and pediatric low-grade optic gliomas. The underlying mechanisms involve both neuronal-activity-regulated paracrine signaling and direct electrochemical communication through neuron-to-glioma synapses. Neuronal inputs to tumors can then be propagated through connections between cancer cells. In turn, brain cancers such as gliomas remodel neural circuits to increase excitability, thereby augmenting the tumor-promoting effects of brain activity and contributing to tumor-associated seizures and neurological impairments, including cognitive deficits. These principles of neuron-cancer interactions are proving to be relevant to other cancers in the brain and the body, underscoring the importance of approaching cancers from a neuroscience perspective.