Nat Commun.  2024  Apr  29.  15(1): 3602
Cathy Pichol-Thievend, 
Oceane Anezo, 
Aafrin M Pettiwala, 
Guillaume Bourmeau, 
Remi Montagne, 
Anne-Marie Lyne, 
Pierre-Olivier Guichet, 
Pauline Deshors, 
Alberto Ballestín, 
Benjamin Blanchard, 
Juliette Reveilles, 
Vidhya M Ravi, 
Kevin Joseph, 
Dieter H Heiland, 
Boris Julien, 
Sophie Leboucher, 
Laetitia Besse, 
Patricia Legoix, 
Florent Dingli, 
Stephane Liva, 
Damarys Loew, 
Elisa Giani, 
Valentino Ribecco, 
Charita Furumaya, 
Laura Marcos-Kovandzic, 
Konstantin Masliantsev, 
Thomas Daubon, 
Lin Wang, 
Aaron A Diaz, 
Oliver Schnell, 
Jürgen Beck, 
Nicolas Servant, 
Lucie Karayan-Tapon, 
Florence M G Cavalli, 
Giorgio Seano.
 
  Glioblastoma (GBM) is a highly lethal type of cancer. GBM recurrence following chemoradiation is typically attributed to the regrowth of invasive and resistant cells. Therefore, there is a pressing need to gain a deeper understanding of the mechanisms underlying GBM resistance to chemoradiation and its ability to infiltrate. Using a combination of transcriptomic, proteomic, and phosphoproteomic analyses, longitudinal imaging, organotypic cultures, functional assays, animal studies, and clinical data analyses, we demonstrate that chemoradiation and brain vasculature induce cell transition to a functional state named VC-Resist (vessel co-opting and resistant cell state). This cell state is midway along the transcriptomic axis between proneural and mesenchymal GBM cells and is closer to the AC/MES1-like state. VC-Resist GBM cells are highly vessel co-opting, allowing significant infiltration into the surrounding brain tissue and homing to the perivascular niche, which in turn induces even more VC-Resist transition. The molecular and functional characteristics of this FGFR1-YAP1-dependent GBM cell state, including resistance to DNA damage, enrichment in the G2M phase, and induction of senescence/stemness pathways, contribute to its enhanced resistance to chemoradiation. These findings demonstrate how vessel co-option, perivascular niche, and GBM cell plasticity jointly drive resistance to therapy during GBM recurrence.