The interplay between tumor cells and the immune microenvironment is crucial in understanding cancer progression and treatment responses. A study on glioblastoma revealed that macrophages can induce a transition of glioblastoma cells into mesenchymal-like states, which are associated with increased aggressiveness and therapy resistance (ref: Hara doi.org/10.1016/j.ccell.2021.05.002/). This finding underscores the importance of the tumor microenvironment in shaping cancer cell phenotypes. Additionally, research on colorectal cancer identified circ3823 as a significant factor in tumor growth and metastasis, implicating the miR-30c-5p/TCF7 axis in these processes (ref: Guo doi.org/10.1186/s12943-021-01372-0/). Furthermore, the role of fatty acid synthesis in breast cancer brain metastasis was highlighted, showing that tumors in the brain exhibit elevated fatty acid synthesis as an adaptation to the unique metabolic environment (ref: Ferraro doi.org/10.1038/s43018-021-00183-y/). These studies collectively emphasize the dynamic interactions between tumor cells and their microenvironment, which can influence tumor behavior and therapeutic outcomes.

Innovative therapeutic strategies are emerging in neuro-oncology, particularly in the context of gliomas and other brain tumors. A phase I trial demonstrated the safety and feasibility of oncolytic virotherapy using herpes simplex virus-1 combined with radiation for pediatric high-grade gliomas, showing promising immune activation post-treatment (ref: Kessler doi.org/10.1016/j.ccell.2021.05.014/). Additionally, the blockade of PD-1 was found to enhance ILC2-dependent antitumor immunity in melanoma, suggesting that targeting immune checkpoints could improve patient outcomes (ref: Jacquelot doi.org/10.1038/s41590-021-00943-z/). The development of CAR T cells targeting glioblastoma also shows potential, although challenges such as tumor heterogeneity remain (ref: Rousso-Noori doi.org/10.1038/s41467-021-23817-2/). Moreover, the SNO and EANO guidelines recommend against the routine use of anticonvulsants in newly diagnosed brain tumor patients without seizures, indicating a shift towards more evidence-based management practices (ref: Walbert doi.org/10.1093/neuonc/). These advancements highlight the ongoing evolution of therapeutic approaches in neuro-oncology, focusing on both direct tumor targeting and modulation of the immune response.

Understanding the molecular mechanisms underlying brain tumors is essential for developing targeted therapies. A study on diffuse intrinsic pontine glioma (DIPG) patients revealed that older age and longer symptom duration are associated with long-term survival, providing insights into patient characteristics that may influence outcomes (ref: Erker doi.org/10.1093/neuonc/). Additionally, the IMPASSE study compared the progression of incidental meningiomas under active surveillance versus stereotactic radiosurgery, finding significantly better tumor control in the latter group (ref: Sheehan doi.org/10.1093/neuonc/). Furthermore, research on glioblastoma stem-like cells identified prohibitin as a key regulator of mitochondrial ROS, which is crucial for maintaining therapeutic resistance (ref: Huang doi.org/10.1038/s41467-021-24108-6/). These findings underscore the importance of genetic and molecular profiling in understanding tumor behavior and guiding treatment strategies.

Clinical management of brain tumors is evolving with new insights into patient outcomes and treatment efficacy. A study on intracranial pressure monitoring in acute brain injury patients found that higher tumor-infiltrating lymphocyte counts were associated with reduced mortality, suggesting that immune profiling may inform prognosis (ref: Robba doi.org/10.1016/S1474-4422(21)00138-1/). Additionally, a real-world analysis of pyrotinib in HER2-positive metastatic breast cancer patients with brain metastasis reported promising progression-free and overall survival rates, indicating its potential as a therapeutic option (ref: Anwar doi.org/10.1158/1078-0432.CCR-21-0474/). The integration of genomic approaches to understand the cell-to-cell transfer of α-synuclein in Parkinson's disease also highlights the importance of molecular insights in managing neurological conditions (ref: Kara doi.org/10.1016/j.celrep.2021.109189/). These studies reflect a trend towards personalized medicine in neuro-oncology, where patient-specific factors are increasingly considered in treatment planning.

The mechanisms underlying brain metastasis and their treatment are critical areas of research in oncology. A study investigating the impact of low-dose computed tomography (LDCT) screening for primary lung cancer found that it significantly reduced the risk of developing brain metastasis, particularly in early-stage patients (ref: Su doi.org/10.1016/j.jtho.2021.05.010/). This suggests that early detection may play a vital role in preventing metastatic spread. Additionally, the NIBIT-M2 trial provided insights into the efficacy of ipilimumab combined with fotemustine or nivolumab in melanoma patients with brain metastases, demonstrating the potential for immunotherapy in this challenging cohort (ref: Di Giacomo doi.org/10.1158/1078-0432.CCR-21-1046/). Furthermore, the interactions between tumor cells and the immune microenvironment, as seen in glioblastoma, highlight the complexity of brain metastasis and the need for multifaceted treatment approaches (ref: Hara doi.org/10.1016/j.ccell.2021.05.002/). These findings emphasize the importance of early intervention and innovative therapies in managing brain metastases.

Preclinical models are essential for advancing our understanding of brain tumors and testing new therapies. A novel immune-competent Syrian hamster glioma model was developed to evaluate oncolytic adenoviruses, providing a platform for studying viral replication and immune responses in glioblastoma (ref: Phillips doi.org/10.1093/neuonc/). Additionally, research on the αv integrin/TGF-β axis demonstrated that targeting this pathway can enhance natural killer cell function against glioblastoma stem cells, offering a promising therapeutic strategy (ref: Shaim doi.org/10.1172/JCI142116/). Furthermore, the association between airport-related ultrafine particles and malignant brain cancer risk was explored, highlighting environmental factors in tumorigenesis (ref: Wu doi.org/10.1158/0008-5472.CAN-21-1138/). These studies illustrate the importance of diverse preclinical approaches in elucidating tumor biology and developing effective treatments.

Radiation therapy remains a cornerstone in the management of brain tumors, with ongoing research refining its application. The SNO and EANO guidelines emphasize that anticonvulsant drugs should not be routinely prescribed to patients with newly diagnosed brain tumors who have not experienced seizures, reflecting a shift towards evidence-based practices (ref: Walbert doi.org/10.1093/neuonc/). Moreover, the safety and efficacy of efgartigimod in treating generalized myasthenia gravis were assessed, indicating its potential relevance in neuro-oncology (ref: Howard doi.org/10.1016/S1474-4422(21)00159-9/). Additionally, functional annotation of breast cancer risk loci has implications for understanding tumor biology and treatment responses, further integrating genetic insights into radiation therapy strategies (ref: Baxter doi.org/10.1016/j.ajhg.2021.05.013/). These findings highlight the evolving landscape of radiation therapy and its integration with other therapeutic modalities in neuro-oncology.