How Glioblastoma ‘Hijacks’ the Skull — and Why Treatments Fail
For decades, we’ve viewed glioblastoma as a strictly local brain malignancy. It turns out, it’s actually a systemic disease that physically remodels and even dissolves the skull.
In my latest feature for Medscape, I break down a years-long study at the Albert Einstein College of Medicine that reveals how glioblastoma activates osteoclasts, which eat away at and dissolve the top of the skull to create porous channels.
These channels then act as a highway of sorts, allowing the tumor to hijack the skull’s bone marrow so it stops producing cancer-fighting lymphocytes and instead pumps out a flood of myeloid cells that protect the tumor.
Most surprising of all, when the researchers used standard osteoporosis drugs like zoledronic acid and anti-RANKL antibodies to save the skull bone, it actually protected the tumor, whereby it continued to pump out a supply of immune-suppressing cells unfettered.
This stunning finding challenges how we manage bone loss in glioblastoma patients, pointing us toward more specific immunotherapy targets rather than standard bone-preserving drugs.
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