GBM treatment includes maximal surgical resection, if possible, followed by radiation therapy and the alkylator molecule temozolomide (TMZ) 26, 27, 28, 29, 30. However, the role of TNT or tumor microtubes in glioblastoma (GBM) have only recently been explored 14, 15, 16, 17, 18, 19, 20, 21, 22, 23.ĭespite the aggressive treatment, the 2-year survival for GBM patients remains only in the 10–25% range, with few patients surviving beyond 5 years 24, 25. We and others demonstrated that TNT formation participates in the pathogenesis of several diseases, including HIV 9, 10, 11, 12, 13. Normally, TNT formation and associated intercellular communication participate in key biological processes, including development, signaling, and the immune response, but TNT formation during healthy conditions is minimal 1, 2, 3, 4, 5, 6, 7, 8. Several groups have suggested that TNT, cytonemes, and tumor microtubes are different structures, but without specific markers or detailed characteristics, these claims are unsupported and require further research 1. TNT are cellular processes that enable cell-to-cell communication at distances from 30 to 500 µm. Tunneling nanotubes (TNT), also called cytonemes in Drosophila and tumor microtubes in mouse tumors, are the only cell-to-cell communication system that enables the long-range exchange of cytoplasmic factors and organelles between connected cells.
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