Scientists have discovered that cancerous cells in an aggressive type of childhood brain tumor work together to infiltrate the brain, and this finding could ultimately lead to much needed new treatments, according to a new study published in Nature Medicine.

In the study, the researchers investigated a type of childhood brain tumor called diffuse intrinsic pontine glioma (DIPG), shining a light on its most aggressive characteristic - its ability to leave the brain stem and send cancer cells to invade the rest of the brain.

DIPG is incredibly difficult to treat. Nearly all children with this type of cancer die within two years.

The researchers used donations of biopsy tissue and the brains of children who had died as a consequence of DIPG to look deep into the tumor and learn more about its cells.

They found that DIPGs are heterogenous, meaning they are made up of more than one type of cell. This enables the cells to 'work' together to leave the original tumor and travel into the brain. The scientists say this shows how complex the genetic make-up of the disease is and that a multi-pronged attack is likely to be necessary for treatment.

The study lead said: "This is the first time we've observed this sort of interaction between different tumor cells in DIPG. The idea that the cells are working together to make the disease grow and become aggressive is new and surprising. Childhood cancers were thought to be very simple but this shows us that isn't always the case. Crucially, this gives us hope that we can develop new treatments.

The study also shows that even cells that exist in relatively small numbers in DIPG can exert a profound influence, by leading cells from the main tumor into the rest of the brain to stimulate tumor growth and spread.

In this study, researchers saw one type of cell leaving the original DIPG tumor site and migrating into the rest of the brain. This happens early in the evolution of the disease and is a cell type found in relatively small numbers. As it migrates, the cells release a chemical messenger called CXCL2, which has the effect of calling other cells from the tumor to follow it.

The next stage of research will see the researchers looking for treatments that target the most important subpopulations of cells in the tumor and/or interfere with the cooperation between cells.

https://www.cancerresearchuk.org/about-us/cancer-news/press-release/2018-07-02-teamwork-between-cells-fuels-aggressive-childhood-brain-tumour

https://www.nature.com/articles/s41591-018-0086-7