Guiding glioblastoma treatments by decrypting tumor biomechanics via Magnetic Resonance Elastography.

Glioblastoma multiforme (GBM) is the most common and deadly type of primary brain tumour, carrying a dire prognosis with a median survival of 14.6 months for patients undergoing standard treatments. The causes of poor clinical prognosis are late diagnosis, diffuse infiltration, pseudo necrosis, high neovascularization and resistance to therapy. In principle, drugs can reach the tumors via the vascular system, but the tumor microenvironment plays the role of an antagonist to any efficient drug delivery whereby reducing treatment efficacy. Recent treatments combine chemotherapy with drugs which aim at re-normalising the tumor microenvironment by releasing the mechanical pressure and/or by reducing the angiogenesis. However, there are yet no imaging biomarkers clinically available which can disentangle the different effects of the therapy on the components of the TME. This hinders patient management in particular dosage. GLIOBID project aim at disentangling the therapy impact on tissue integrity and pressure from the modulation of tumour vasculature by quantifying tissue rheology with magnetic resonance Elastography (MRE). This imaging breakthrough will allow to assess the effect of treatments on the main target – the tumor - and the pathways to reach it – the vessels and the tumour microenvironment - providing a unique guidance to tailor combined therapies based on component-specific biomarkers. GLIOBID will involve the main experts in the field of imaging and cancer biology, creating a highly multidisciplinary and eminently clinical environment. This together with the complementary expertise of researcher and hosting institutions will provide the best conditions for decrypting the complexity of the problem and find approaches translatable to the clinical routine. GLIOBID will potentially allow a paradigm shift from the current TREAT-THEN-OBSERVE approach to an OBSERVE-THUS-TREAT approach.