THE ROLE OF NEURON-TO-GLIOMA SYNAPTIC COMMUNICATION IN THERAPEUTIC RESISTANCE

Abstract Glioblastomas, primary brain tumors known for their extensive brain colonization and high therapeutic resistance, pose significant treatment challenges. Recent research has revealed that glioblastoma cells can form functional multicellular networks both with themselves, surrounding astrocytes and neurons. However, the investigation of the glioblastoma neuronal connectome has been limited by a lack of suitable methodologies. In this study, we utilized an adapted rabies-based retrograde tracing approach to characterize tumor-connected neurons and examine the neuronal connectome of the tumor in the context of therapy resistance. Our initial findings demonstrated that radiotherapy induces hyperexcitability in tumor-connected neurons, as shown by patch-clamp electrophysiology. This hyperexcitability was associated with an increase in neuron-tumor connectivity post-irradiation. To mitigate this increased neuronal input to therapy-resistant glioblastoma cells, we combined radiotherapy with the anti-epileptic drug perampanel. This combination therapy, which inhibits overall neuronal activity while delivering tumor cell-toxic photon irradiation, proved significantly more effective in reducing the number of therapy-resistant tumor cells. In summary, we employed a novel methodology to investigate the role of the neuronal tumor connectome in therapeutic resistance, identifying tumor-connected neurons as a potential target for improving glioblastoma treatment.