In this podcast a new biological insight in brain tumors is discussed by Frank Winkler, DKFZ, CCU Neurooncology, Heidelberg, Germany ([email protected]).The author’s group has identified the existence of a tumor cell network in incurable gliomas which facilitates multicellular communication and exchange of small molecules between single tumor cells. The tumor cells that are integrated in this network, around 50% of cells according to studies in mouse models and patient samples, appear to be protected from the effects of radiotherapy and possibly also chemotherapy, which may explain how such tumors develop resistance to therapies and why patients relapse after treatment. An overview of ideas that are being investigated preclinically to therapeutically target this network of tumor cells is given. These include approaches to disrupt the network, such as obstructing cellular communication with gap junction blockers and targeting the neurodevelopmental pathways required to form the networks. Conversely, methods to exploit the network through the local application of gap-permeable drugs which specifically target the integrated tumor cells could also be studied. This new discovery may result in the development of therapeutic strategies which the author hopes will reach the clinic in the next few years.

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