The tumor microenvironment is composed of heterogeneous populations of cells, including cancer, immune, and stromal cells. Progression of tumor growth and initiation of metastasis is critically dependent on the reciprocal interactions between cancer cells and stroma. Through RNA-Seq and protein analyses, we found that cancer-associated fibroblasts derived from human breast cancer brain metastasis express significantly higher levels of chemokines CXCL12 and CXCL16 than fibroblasts from primary breast tumors or normal breast. To further understand the interplay between cancer cells and cancer-associated fibroblasts from each site, we developed three-dimensional organoids composed of patient-derived primary or brain metastasis cancer cells with matching cancer-associated fibroblasts. Three-dimensional CAF aggregates generated from brain metastasis promote migration of cancer cells more effectively than cancer-associated fibroblast aggregates derived from primary tumor or normal breast stromal cells. Treatment with a CXCR4 antagonist and/or CXCL16 neutralizing antibody, alone or in combination, significantly inhibited migration of cancer cells to brain metastatic cancer-associated fibroblast aggregates. These results demonstrate that human brain metastasis cancer-associated fibroblasts potently attract breast cancer cells via chemokines CXCL12 and CXCL16, and blocking CXCR6-CXCL16/CXCR4-CXCL12 receptor–ligand interactions may be an effective therapy for preventing breast cancer brain metastasis.

Longevity in cancer patients with brain metastases is increasingly being observed. This raises discussions about how best to maintain a good quality of life for these patients. Recent data suggest that post-treatment quality of life (QoL) can be maintained using new treatment options, but little data exist regarding the QoL in long-term survivors. This study of 19 patients surviving greater than two years from the initial treatment of brain metastases suggests that long-term QoL can be better than at the start of treatment and perhaps even better than normal, especially between three and five years post-treatment. This improved QoL seems mostly attributable to improved functional and social well-being and is possible as long as emotional and physical well-being are maintained within the normal range.

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Facebook has become one of the most widely used platforms by patients and caregivers for information on GBM. As such, physicians treating GBM are challenged with reconciling their medical advice with online media sources. In many cases, the information from these online sources can run counter to the advice given by physicians. OBJECTIVE This study sought to understand the type of information being shared on a popular GBM Facebook community titled, “GLIOBLASTOMA SURVIVORS TO THRIVERS!” with regards to 1. The perceived causes of GBM and 2. The therapies that led to GBM remission. METHODS All the posts in a 30-day period (5/01/2019-6/01/2019) were screened for information on GBM etiologies and GBM therapies. Within each group, posts were sorted into distinct sub-categories with posts of similar content. The sub-categories were ranked to determine which etiologies and therapies were most commonly seen by group members. RESULTS A total of 83 posts were on the topic of “GBM Etiologies” and 80 on the topic of “GBM Therapies.” Within the “GBM Etiologies”, the reasons for developing GBM were due to 1. Unknown (31.3%) 2. Previous Radiation Exposure (24.1%) 3. Chemical Exposure (17%) 4. Genetic (12%) 5. Infectious Disease (6%) 6. Losartan/Valsartan (4.8 %). and 7. Head Trauma (2.4%) and Emotional Trauma (2.4%). Within the GBM Therapy category, the therapies that led to remission were 1. Standard of Care (36.3%) 2. CBD/THC (16.3%) 3. Ketogenic Diet (12.5%) 4. Avastin (7.5%) and Optune (7.5%) 5. IV Vitamin C (6.25%) and COC Protocol (6.25%) 6. Meditation/Yoga/Acupuncture (5.0%) and 7. Faith Healing (2.5%). CONCLUSION In the Facebook group titled, ““GLIOBLASTOMA SURVIVORS TO THRIVERS!,” the top three most commonly posted reasons for developing GBM were “Unknown” “Previous Radiation Exposure” and “Chemical Exposure.” The top three therapies that led to remission were “Standard of Care” “CBD/THC” and “Ketogenic Diet.”

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