On 2013 Nov 08, Allison Stelling commented:

The molecular characterization for glioblastoma section of this paper was a bit weak; unfortunately due to a paucity of work in this field. I realize the whole field is desperate for cures for this rather frightening class of brain tumor. However, its very heterogeneity renders it a formidable foe. We need better maps of this undiscovered molecular territory if we are to even hope for a targeted strategy with chemotherapies. Genetic and morphological information gives me a few pieces of the picture, but I need to know the spatially resolved biochemistry to mount an effective chemical attack.

The authors state in their neurosurgery section "In inoperable tumors, stereotactic biopsy may be performed for histologic diagnosis, but the limited amount of tissue acquired may preclude full molecular characterization."

Optical methods like Raman and infrared spectroscopy can help to directly address this issue, since they are (a) non-invasive and (b) you can get reliable phenotype information about the biochemistry from quite small tissue samples (for example, ratios of lipids to proteins) fairly rapidly (see my paper Stelling AL, 2013; as well as recent work on skin cancer Kong K, 2013 for more).

On a final note: I've chatted with a few neuropathologists. Even when the entire brain hemisphere with the tumor in it is removed, there's still recurrence. I strongly suspect after the cancerous cells are present (after they have evolved from the stem cells etc), they leave behind carcinogenic contamination. There's some studies on the extracellular matrix of gliomas pointing to a role for these structural proteins and sugars in progression and recurrence as well. (See Payne LS, 2013 for a recent review.)

On 2013 Nov 08, Allison Stelling commented:

The molecular characterization for glioblastoma section of this paper was a bit weak; unfortunately due to a paucity of work in this field. I realize the whole field is desperate for cures for this rather frightening class of brain tumor. However, its very heterogeneity renders it a formidable foe. We need better maps of this undiscovered molecular territory if we are to even hope for a targeted strategy with chemotherapies. Genetic and morphological information gives me a few pieces of the picture, but I need to know the spatially resolved biochemistry to mount an effective chemical attack.

The authors state in their neurosurgery section "In inoperable tumors, stereotactic biopsy may be performed for histologic diagnosis, but the limited amount of tissue acquired may preclude full molecular characterization."

Optical methods like Raman and infrared spectroscopy can help to directly address this issue, since they are (a) non-invasive and (b) you can get reliable phenotype information about the biochemistry from quite small tissue samples (for example, ratios of lipids to proteins) fairly rapidly (see my paper Stelling AL, 2013; as well as recent work on skin cancer Kong K, 2013 for more).

On a final note: I've chatted with a few neuropathologists. Even when the entire brain hemisphere with the tumor in it is removed, there's still recurrence. I strongly suspect after the cancerous cells are present (after they have evolved from the stem cells etc), they leave behind carcinogenic contamination. There's some studies on the extracellular matrix of gliomas pointing to a role for these structural proteins and sugars in progression and recurrence as well. (See Payne LS, 2013 for a recent review.)