Identification of a prognostic microenvironment-related gene signature in glioblastoma multiforme patients treated with carmustine wafers

Carmustine wafers (CW) implantation into the resection cavity of patients operated for glioblastoma multiforme (GBM) was approved as adjuvant treatment before the Stupp Protocol. Although contrasting clinical results limited its use, our retrospective study on 116 GBM, treated with CW, showed a significant benefit in terms of OS in a subgroup of patients. Since GBM growth, progression and drug resistance are supported by the surrounding environment and since the tumour microenvironment (TME) is source of druggable targets, we hypothesized that the TME of patients who benefited from CW could have different characteristics compared to patients who did not show any advantage. Exploiting a human in vitro model of glioma microenvironment and a transcriptomic approach, we found a different gene signature suggesting the importance to develop in vitro models that mimic the properties of human cancers and that can help to study individual patient characteristics at cellular and molecular level.