Cancer neuroscience (nerve–tumour signalling)
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.
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.
In one picture
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.
Diagram
top- 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
top- 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.