Glioblastoma (GBM) is the most common and fatal type of
primary brain tumor.
Gliosarcoma (GSM) is a rarer and more aggressive variant of GBM that has recently been considered a potentially different disease. Current clinical treatment for both GBM and GSM includes maximal surgical resection followed by post-operative
radiotherapy and concomitant and
adjuvant chemotherapy. Despite recent advances in treating other solid
tumors, treatment for GBM and GSM still remains palliative, with a very poor prognosis and a median survival rate of 12-15 months. Treatment failure is a result of a number of causes, including resistance to
radiotherapy and
chemotherapy. Recent research has applied the cancer stem cells theory of
carcinogenesis to these
tumors, suggesting the existence of a small subpopulation of
glioma stem-like cells (GSCs) within these
tumors. GSCs are thought to contribute to
tumor progression, treatment resistance, and
tumor recapitulation post-treatment and have become the focus of novel
therapy strategies. Their isolation and investigation suggest that GSCs share critical signaling pathways with normal embryonic and somatic stem cells, but with distinct alterations. Research must focus on identifying these variations as they may present novel therapeutic targets. Targeting pluripotency
transcription factors, SOX2, OCT4, and Nanog homeobox, demonstrates promising therapeutic potential that if applied in isolation or together with current treatments may improve overall survival, reduce
tumor relapse, and achieve a cure for these patients.