Citations

Background: Several breast cancer (BC) risk prediction models have been developed to provide personal risk assessments. Though individually validated, their performance has not been systematically evaluated across a wide range of populations or ages. Methods: We harmonized individual-level baseline questionnaire data and incident BC diagnoses from 21 cohorts from North America, Europe, and Australia participating in the Breast Cancer Risk Prediction Project. Five-year absolute risk of invasive BC was estimated for five established risk prediction models using classical risk factors only. Discrimination was evaluated by area under the curve (AUC). Calibration was assessed using average and risk-decile specific expected to observed (E/O) ratios. Performance metrics were meta-analyzed across cohorts and models. Metaregression tested associations between cohort characteristics and performance metrics. Results: This analysis included 1,595,977 women aged 20-75 years, enrolled in studies between 1976-2015, with 19,062 (1.2%) invasive BC cases ascertained within 5 years from exposure assessment. Age-adjusted AUCs were similar across models and cohorts (pooled AUCs by model: 0.57-0.58), while E/O ratios varied substantially (pooled E/O ratios by model: 0.83-1.25). Overestimation was common among predicted high-risk individuals (>3%). No appreciable differences in model performance by cohort age, birth year, race, and variable missingness emerged. Calibration improved after assigning race-specific incidence rates. Conclusion: Existing BC risk prediction models provided similar risk discrimination across multiple cohorts, although there was overestimation of risk for high-risk individuals. Performance variation across cohorts was not driven by specific characteristics, which supports development of a unified risk model for diverse populations that leverages appropriate incidence rates.

Abstract The purpose of this study was to identify glioblastoma (GBM) proteins that contribute to the hijacking of the tumor microenvironment through extracellular vesicles (EVs). GBM is the most aggressive primary brain tumor in adults. It presents significant challenges due to its universal recurrence and limited survival rates, exacerbated when its located proximal to the lateral ventricles (LV). The cellular subpopulation of brain tumor-initiating cells (BTICs) plays a pivotal role in tumor initiation and invasiveness, interacting with the microenvironment, particularly the cellular components in the subventricular zone (SVZ) in the LV. We employed an integrated multi-omic strategy combining cell-specific proteomics of EV cargo and whole-cell transcriptomics of EV-treated neural progenitor cells (NPCs) to define mechanisms by which BTICs remodel the tumor microenvironment. Using the TurboID cell-specific protein labeling system, we identified a previously unrecognized repertoire of BTIC-derived proteins selectively packaged into EVs. Among these, DPYSL2 (CRMP2) emerged as a prominent EV cargo as it is implicated in cancer cell migration and invasion. Functionally, exposure of human NPCs to BTIC-derived EVs significantly increased NPC proliferation and migratory capacity in vitro, findings that were recapitulated in vivo following intracranial and intranasal delivery of GBM-derived EVs. To define the molecular basis of these phenotypic changes, we performed RNA sequencing of NPCs following EV treatment. Bioinformatic integration, including ontogenic and pathway enrichment analyses, revealed robust activation of oncogenic signaling pathways, notably JAK/STAT, mTOR, and WNT, accompanied by upregulation of downstream effector genes. Importantly, integrative proteomic-transcriptomic analyses identified DPYSL2 as a mechanistic link between EV cargo and NPC transcriptional reprogramming. Prior studies demonstrate that DPYSL2 can interact with JAK kinases, promoting STAT3 activation and transcription of genes such as Vimentin (VIM) and CALCA, consistent with the transcriptomic changes observed in EV-treated NPCs. Overall, we have identified DPYSL2 as a novel regulator of tumor microenvironment hijacking mediated by extracellular vesicles. This multi-omic approach is the first use of cell-specific proteomics to study extracellular vesicles and the first time pairing this method to identify upstream regulators of transcriptomic changes in neural progenitor cells. Collectively, these findings establish a direct molecular connection between BTIC-derived EV proteins and functional reprogramming of neural progenitor cells, providing mechanistic insight into how glioblastoma exploits developmental programs to promote tumor progression. Citation Format: Marissa Russo, Emily Norton, Weiwei Wang, Shreyartha Mukherjee, Daniel Wickland, TuKiet Lam, Hugo Guerrero-Cazares. DPYSL2 mediates extracellular vesicle-driven reprogramming of the glioblastoma tumor microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(8_Suppl):Abstract nr LB228.

Abstract Glioblastoma (GBM) is the most common and aggressive primary brain tumor in adults with a poor prognosis of 15 months despite aggressive therapies. GBM malignancy is often driven by a high degree of inter- and intra-tumoral heterogeneity that is dynamic through time and regulated by interactions between tumor cells and their neural microenvironment. For instance, GBM tumors located near the lateral ventricles (LV) of the brain grow more aggressively and result in significantly worse patient survival, compared to tumors that grow far from the LV. This suggests that interactions between GBM and cells in the LV microenvironment may regulate tumor malignancy. Understanding the mechanisms underlying GBM malignancy near the LV is essential to determine if regulation of tumor biology is driven by the presence of healthy neural cells, and to ultimately develop therapeutic approaches that target GBM-LV interactions. Here, we tested the hypothesis that region-specific cellular identities and activation of unique transcriptional programs regulate GBM malignancy near the LV. Paired primary biopsies were collected from 14 GBM patients. Image-guided biopsies proximal and distal to the brain’s LV (LV-proximal GBM and LV-distal GBM, respectively) were processed for bulk RNA sequencing, single-nucleus RNA sequencing, and in situ spatial transcriptomic (Xenium) analyses. We found significant inter-patient and intra-tumoral transcriptional heterogeneity in GBM samples collected proximal and distal to the LV. After accounting for tumoral and patient heterogeneity, we found that proximal GBM tumors exhibit an increased immune-related gene signature, compared with tumors distal to the LV. Single-nucleus RNA sequencing and in situ spatial transcriptomic analyses showed no significant differences in the proportion of cellular states or identities between proximal and distal GBM samples. However, within each cellular identity, significant differences in gene expression were identified between proximal and distal GBM, suggesting that distinct cell-specific transcriptional pathways characterize regional differences in GBM biology. Our results suggest that GBM tumors near the LV have increased interactions with immune cells that lead to the enrichment of immune-related transcriptional pathways, compared to tumors growing far from the LV. This work will inform the development of therapies that target GBM-immune cell interactions to decrease tumor malignancy and improve individual patient outcomes. Citation Format: Maria F. Gonzalez-Aponte, Jhan C. Salazar, Aura Figueroa-Gonzalez, Emily S. Norton, Paola Suarez-Meade, Hugo Guerrero-Cazares. Integrating RNA sequencing and spatial transcriptomic analyses reveals drivers of glioblastoma malignancy near the brains’ lateral ventricles [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Brain Cancer; 2026 Mar 23-25; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2026;86(6_Suppl):Abstract nr B035.

Abstract Glioblastoma (GBM), the most common malignant primary brain tumor in adults, has a median survival of 15 months and 5-year survival rate of only 6.9%. Standard of care, including radiation and chemotherapy, can induce cellular senescence in the brain. The senescence-associated secretory phenotype (SASP) significantly affects glioma microenvironment as these secreted factors exhibit both anti-and pro-tumorigenic effects. However, it is currently unknown whether senescence in the surrounding GBM microenvironment could be beneficial or detrimental to tumor outcomes. Using cell-specific proteomics, we identified upregulation of cathepsin B (CTSB) expression in patient-derived brain tumor initiating cells (BTICs) co-cultured with human fetal neural progenitor cells (NPCs). In matched patient tumor biopsies, sequencing of lateral ventricle (LV)-proximal regions revealed increased CTSB expression compared to LV-distal counterparts. Remarkably, LV-proximal GBMs induced a senescent phenotype and reduced differentiation in subventricular zone (SVZ) NPCs through CTSB secretion. We hypothesize that senescent NPCs in the SVZ contribute to a pro-tumorigenic microenvironment that promotes tumor aggressiveness in LV-proximal GBM. To model this in vitro, senescence was induced in NPCs using recombinant CTSB (100 nM) and hydrogen peroxide (250 µM, 2 hours). Treated NPCs showed increased β-galactosidase activity and increased expression of SASP factors IL-1α, IL-6, and CTSB. Senescent NPCs significantly increased BTIC migration and proliferation (p<0.05) both in co-culture and through conditioned media, suggesting this effect may be mediated by soluble factors. These findings support the hypothesis that senescent NPCs promote BTIC malignancy in LV-proximal GBM and identify CTSB as a potential mediator of this interaction.

Abstract Glioblastoma (GBM), the most aggressive primary brain tumor in adults, presents significant challenges due to its universal recurrence and limited survival rates, exacerbated when proximal to the lateral ventricles (LV). The subpopulation of brain tumor-initiating cells (BTICs) plays a pivotal role in tumor initiation and invasiveness, interacting with the microenvironment, particularly the cellular components in the subventricular zone (SVZ), like Neural Progenitor Cells (NPCs). Mechanisms of intercellular communication present in the SVZ include paracrine, autocrine, direct cell contact, and more recently extracellular vesicles (EVs). EVs are membrane-bound particles released by cells that are central to intercellular communication. They carry bioactive proteins, RNA, and other molecules that influence recipient cell behavior. This study investigates the role of EVs in GBM’s communication with non-cancer cells. Our findings indicate that BTIC-derived EVs promote migration and proliferation (*p < 0.02, ****p <0.001) in NPCs in vitro, highlighting the EVs’ role in altering the microenvironment. Additionally, we leverage a multi-omic approach to profile the small RNA and protein cargo of BTIC-EVs while also evaluating changes in the transcriptome of NPCs after BTIC-EV treatment. To identify the protein cargo contained in GBM-derived EVs, we utilized the innovative proximity-labeling system TurboID. We successfully induced TurboID expression in primary-cultured human BTICs from GBM patients, enabling the unbiased biotinylation of proteins in EVs. This method marks the first implementation of TurboID for unbiased global labeling of EV protein cargo in primary GBM cells. We identified unique miRNAs to be regulators of NPC’s transcriptome, and ontogenic analysis revealed upregulation of pathways involved in maintaining stem-like state, and upregulating PI3k-AKT, mTOR, and WNT signaling. This approach facilitates the investigation of EV-mediated communication and potential therapeutic targets, contributing to the understanding of GBM’s complex interactions with the brain’s microenvironment and the identification of biomarkers for improved diagnosis and treatment response.

Abstract NF2-related schwannomatosis is a genetic condition characterized by mutation in the NF2 gene resulting in tumor formation throughout the nervous system. The most common tumors in these patients include bilateral vestibular schwannomas and multiple meningiomas which, despite their benign classification, lead to significant neurologic deficits including hearing loss, ataxia, hydrocephalus, and brainstem compression. Loss of NF2, which encodes the protein Merlin, is also the most common mutation in spontaneous meningiomas and schwannomas. Current treatment consists of resection followed by radiation for more aggressive tumors. Unfortunately, these treatments are not curative and are associated with significant risk due to tumor location, involvement of neurovasculature, cognitive impairment, and radiation-induced tumor induction. Therefore, identifying additional therapeutics for these patients is critical. Molecular profiling across large cohorts of sporadic meningiomas have identified molecular signatures associated with NF2 mutation, indicating upregulation of Wnt5a/b and the alternative Wnt5a/b-YAP/TAZ signaling pathway. In NF2 knock-out human arachnoid and Schwann cells, we find a significant upregulation of YAP in NF2-null lines compared to controls. Additionally, when stimulated with Wnt5a/b, controls upregulate both beta catenin (canonical Wnt) and YAP (alternative Wnt). However, in NF2-null lines only YAP is increased, indicating a preference for the alternative pathway in the absence of canonical Wnt signaling. In primary NF2-mutant meningioma lines, targeting this pathway via blocking Wnt secretion with the inhibitor LGK974 or YAP signaling with verteporfin, which is FDA approved, results in decreased cell viability and proliferation in vitro. These results indicate activation of the Wnt5a/b-YAP/TAZ alternative signaling pathway in NF2-mutant meningeal and Schwann cells, and a potential therapeutic effect of blocking this pathway in NF2-mutant meningiomas with a previously-FDA approved inhibitor. Additional research is needed on the receptors and molecular mediators playing a role in this pathway and how these drugs may have therapeutic benefits in vivo

ABSTRACT Glioblastoma (GBM), the most aggressive primary brain tumour in adults, presents significant challenges due to its universal recurrence and limited survival rates. A key driver of GBM progression is the subpopulation of brain tumour‐initiating cells (BTICs), which contribute to therapy resistance and interact with the tumour microenvironment, particularly the cellular components in the subventricular zone (SVZ). Extracellular vesicles (EVs) are critical mediators of intercellular communication, carrying bioactive molecules, such as proteins and RNAs, that can modulate the behaviour of recipient cells. This study investigates the role of EVs in GBM's communication with non‐cancer cells. We utilised the proximity‐labelling system TurboID to achieve global and unbiased labelling of proteins within GBM‐derived EVs. By inducing TurboID expression in primary‐cultured human BTICs from GBM patients, we achieved efficient biotinylation of EV proteins without compromising vesicle integrity, and performed proteomic analysis of biotinylated proteins, which revealed a diverse cargo within BTIC‐EVs. Our method marks the first implementation of TurboID for unbiased global labelling of EV protein cargo in primary cells. This approach facilitates the investigation of EV‐mediated communication and potential therapeutic targets, contributing to the understanding of GBM's complex interactions with the brain's microenvironment and identification of biomarkers for improved diagnosis and treatment response.

Abstract Glioblastoma (GBM), the most aggressive primary brain tumor in adults, presents significant challenges due to its universal recurrence and limited survival rates, exacerbated when proximal to the lateral ventricles (LV). The subpopulation of brain tumor-initiating cells (BTICs) plays a pivotal role in tumor initiation and invasiveness, interacting with the microenvironment, particularly the cellular components in the subventricular zone (SVZ). Some mechanisms of intercellular communication present in the SVZ include paracrine, autocrine, direct cell contact, gap junctions, nanotubes, and more recently extracellular vesicles (EVs). EVs are membrane-bound particles released by cells that are central to intercellular communication. They have the ability to carry bioactive proteins, RNA, and other molecules that influence recipient cell behavior.This study investigates the role of EVs in GBM's communication with non-cancer cells. Our findings indicate that BTIC-derived EVs promote migration and proliferation (*p < 0.02, ****p <0.001) in neural progenitor cells (NPCs) in vitro, highlighting the EVs' role in altering the microenvironment. To identify the protein cargo contained in GBM-derived EVs, we utilized the innovative proximity-labeling system TurboID. We successfully induced TurboID expression in primary-cultured human BTICs from GBM patients, enabling the unbiased biotinylation of proteins in EVs. We isolated biotinylated proteins from BTIC lysates and BTIC-EVs, preserving the integrity of EVs, and conducted proteomic analysis via mass spectrometry. Our method marks the first implementation of TurboID for unbiased global labeling of EV protein cargo in primary GBM cells. This approach facilitates the investigation of EV-mediated communication and potential therapeutic targets, contributing to the understanding of GBM's complex interactions with the brain's microenvironment and the identification of biomarkers for improved diagnosis and treatment response. Citation Format: Marissa Russo, Emily Norton-Ramos, Maria Jose Ulloa Navas, Alfredo Quinones-Hinojosa, Hugo Guerrero-Cazares. Elucidating glioblastoma-derived extracellular vesicle cargo using TurboID: Implications for tumor microenvironment adaptation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6579.

Abstract The extracellular matrix (ECM) plays a critical role in cancer progression, with its biophysical properties influencing cancer behavior. ECM stiffness can induce long-lasting adaptations in cancer cells, promoting sustained invasion through a process known as “mechanical memory” (MM). Glioblastoma (GBM) exhibits spatial heterogeneity in stiffness, with stiffer ECM found at the tumor periphery where invasive cells reside and promote recurrence. We hypothesize that increased stiffness at the tumor periphery primes GBM cells for sustained invasion through MM. METHODS Cell lines were established from image-guided human GBM samples from tumor margin and core (n=10 patients, 20 cell lines). Cells from random locations were conditioned in physiologically relevant extracellular matrices for two weeks. Human organotypic assay (n=3), Migration Assays, Atomic Force Microscopy (AFM), Immunocytochemistry, Western Blot, and RNA-sequencing (n=6) were performed. RESULTS GBM cells at higher stiff surfaces displayed increased migration (p<0.01). Magnetic Resonance Elastography (n=9) confirmed GBM heterogeneity, with softer cores (0.2-0.5kPa) transitioning to stiffer margins (>2kPa). Organotypic scaffolds mimicking the tumor margin promoted enhanced migration of GFP-labeled GBM cells. Margin cells and cells conditioned on stiffer matrices demonstrated higher migratory potential compared to their core and soft-conditioned counterparts (p<0.05). These trends persist over time and across multiple passages. ECM stiffness exposure causes nanomechanical, cytoskeletal, and transcriptional adaptations. AFM shows that cells from the margin (n=6) are softer (p<0.01) and more deformable (p<0.01). RNAseq identified upregulation of MM-specific genes in GBM margin cells. The mechanosensitive transcription factor YAP1 emerged as a key driver of MM. Notably, YAP1 is targetable by the FDA-approved drug Verteporfin. YAP1 expression was elevated in margin and stiff-conditioned cells (p<0.05). Stiff-conditioned cells and margin cells displayed increased sensitivity to Verteporfin treatment (p<0.05), with treatment significantly reducing margin migration compared to the core (p<0.001). CONCLUSION Stiffer GBM margins promote the formation of aggressive phenotypes through MM. Targeting YAP1 with Verteporfin, a readily available drug, presents a promising strategy to halt GBM invasion and improve patient outcomes.

Abstract Glioblastoma (GBM) is the most common malignant primary brain tumor in adults with a median survival of 8-14 months and 5-year survival rate of 6.9%. Its aggressive nature arises mostly from molecular heterogeneity and resistance to standard of care (SOC), including radiation and temozolomide (TMZ). Recurrence is nearly inevitable, driven by highly invasive brain tumor initiating cells (BTICs). Our previous studies revealed that exposing BTICs to cerebrospinal fluid (CSF) from GBM patients increases cell migration and proliferation compared to non-cancer CSF. Transcriptomic analysis identified the upregulation of the SERPINA3 gene, which encodes alpha-1-antichymotrypsin (ACT). Silencing of SERPINA3 reduces BTIC migration and proliferation and abolishes the promigratory response to GBM-derived CSF, highlighting SERPINA3 as a potential therapeutic target. ACT has been reported to bind to DNA, although the implications of this interaction are unknown. We have previously observed higher levels of intranuclear ACT in human GBM compared to non-cancer brain tissues. We hypothesize that the nuclear localization of SERPINA3 in GBM contributes to increased malignancy, opening the possibility of therapeutically targeting its intranuclear transport. Here, we determined the intracellular localization of ACT in BTICs and GBM and compared it to non-cancer tissues. Additionally, we evaluated whether SOC affected intranuclear localization of ACT. Patient-derived BTICs were treated with TMZ, radiation, and a combination of both, to assess changes in ACT expression via Western Blot, PCR, and ICC. A decrease in cell confluency was correlated with a significant decrease (p<0.05) in SERPINA3 mRNA and overall protein expression when BTICs were treated with TMZ alone or in combination. Interestingly, confocal microscopy revealed a significant increase (p<0.05) in its nuclear localization, particularly with TMZ treatment, indicating a change in its intracellular distribution. Overall, nuclear translocation of SERPINA3 increases in response to SOC with potential implications as a treatment resistance mechanism.