# Cancer neuroscience (nerve-tumour signalling)

Source: https://onco.cc/pathways/cancer-neuroscience/  
OnCo record `cancer-neuroscience` (Pathway). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cancer neuroscience is the study of how tumours talk to nerves. Nerves grow into tumours and feed them signals; brain tumours even wire themselves into neural circuits. Cutting the conversation with common drugs such as beta-blockers is now being tested.

## Summary

Perineural invasion predicts poor outcome in pancreatic, prostate, and head and neck cancer; sympathetic (β-adrenergic) and parasympathetic (muscarinic) signalling promotes growth and metastasis; tumours secrete NGF and axon-guidance factors to recruit nerves. Gliomas form functional synapses with neurons (AMPA receptors) and hijack activity-regulated neuroligin-3; neuronal activity drives glioma growth. Interventions: β-blockers (propranolol trials in melanoma, breast, angiosarcoma), botulinum toxin denervation (gastric cancer trial), NGF/TrkA blockade, AMPA antagonists (perampanel) in glioma, and gabapentinoids. A young field with strong preclinical evidence and early clinical signals.

## Fields

- Kind: Pathway
- Last checked: 2026-09-08
- Tags: mechanism
- Analogy: A tumour that taps into the city's telephone lines: it receives growth orders from the nervous system, and brain tumours go further, plugging themselves into the switchboard so that ordinary brain chatter feeds them.
- Interventions: Propranolol and other β-blockers in trials (melanoma, breast, angiosarcoma); Botulinum toxin denervation trials (gastric); NGF/TrkA and AMPA-receptor (perampanel) blockade; gabapentin in glioma trials; Perineural invasion as a staging biomarker

## Notes

- Leading programmes: Monje (Stanford) on neuron-glioma synapses; Winkler (Heidelberg/DKFZ) on tumour microtubes; Wong (MSK) and Amit (MD Anderson) on nerves in pancreatic and head and neck cancer; Cancer Grand Challenges NexTGen/ neuroscience teams.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Neuro-oncology
- Venkatesh et al., Electrical and synaptic integration of glioma into neural circuits (Nature 2019): https://doi.org/10.1038/s41586-019-1563-y
- Monje et al., Roadmap for the emerging field of cancer neuroscience (Cell 2020): https://doi.org/10.1016/j.cell.2020.03.034

## Connected records

- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Melanoma](https://onco.cc/cancers/melanoma/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- targets: [NTRK](https://onco.cc/targets/ntrk/)
- institutions: [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/), [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/), [Stanford Health Care / Stanford Cancer Institute](https://onco.cc/institutions/stanford/)
- pathways: [The blood-brain barrier & brain metastasis](https://onco.cc/pathways/blood-brain-barrier-metastasis/), [The metastatic cascade](https://onco.cc/pathways/metastatic-cascade/), [Tumour microenvironment (TME)](https://onco.cc/pathways/tumor-microenvironment/)
- key papers: [Electrical and synaptic integration of glioma into neural circuits](https://onco.cc/key-papers/paper-venkatesh-nature/), [Roadmap for the Emerging Field of Cancer Neuroscience](https://onco.cc/key-papers/paper-monje-cell/)
- ideas: [Cut the nerve supply to tumours with old drugs](https://onco.cc/ideas/idea-nerve-tumour-blockade/)
- roadmaps: [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/), [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/)
- terms: [Bioelectric theory of cancer (Levin)](https://onco.cc/terms/bioelectric-theory-of-cancer/)

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