{"entity":{"id":"cancer-neuroscience","kind":"pathway","name":"Cancer neuroscience (nerve-tumour signalling)","aka":[],"tldr":"Cancer neuroscience is the study of how tumours talk to nerves. Nerves grow into tumours and feed them signals; brain tumours even wire themselves into neural circuits. Cutting the conversation with common drugs such as beta-blockers is now being tested.","summary":"Perineural invasion predicts poor outcome in pancreatic, prostate, and head and neck cancer; sympathetic (β-adrenergic) and parasympathetic (muscarinic) signalling promotes growth and metastasis; tumours secrete NGF and axon-guidance factors to recruit nerves. Gliomas form functional synapses with neurons (AMPA receptors) and hijack activity-regulated neuroligin-3; neuronal activity drives glioma growth. Interventions: β-blockers (propranolol trials in melanoma, breast, angiosarcoma), botulinum toxin denervation (gastric cancer trial), NGF/TrkA blockade, AMPA antagonists (perampanel) in glioma, and gabapentinoids. A young field with strong preclinical evidence and early clinical signals.","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Neuro-oncology","links":[{"label":"Venkatesh et al., Electrical and synaptic integration of glioma into neural circuits (Nature 2019)","url":"https://doi.org/10.1038/s41586-019-1563-y"},{"label":"Monje et al., Roadmap for the emerging field of cancer neuroscience (Cell 2020)","url":"https://doi.org/10.1016/j.cell.2020.03.034"}],"tags":["mechanism"],"related":[],"cancers":["pancreatic","prostate","glioblastoma","head-and-neck","melanoma"],"sections":[],"technologies":[],"targets":["ntrk"],"drugs":[],"companies":[],"institutions":["stanford","mskcc","md-anderson"],"pathways":["tumor-microenvironment","metastatic-cascade"],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-venkatesh-nature","paper-monje-cell"],"journals":[],"dependsOn":[],"notes":["Leading programmes: Monje (Stanford) on neuron-glioma synapses; Winkler (Heidelberg/DKFZ) on tumour microtubes; Wong (MSK) and Amit (MD Anderson) on nerves in pancreatic and head and neck cancer; Cancer Grand Challenges NexTGen/ neuroscience teams."],"analogy":"A tumour that taps into the city's telephone lines: it receives growth orders from the nervous system, and brain tumours go further, plugging themselves into the switchboard so that ordinary brain chatter feeds them.","nodes":[{"id":"tum","label":"Tumour","x":50,"y":50},{"id":"ngf","label":"NGF, axon guidance cues","x":25,"y":25},{"id":"nerve","label":"Nerve ingrowth (PNI)","x":25,"y":75},{"id":"adr","label":"β-adrenergic / cholinergic signals","x":75,"y":75},{"id":"syn","label":"Neuron-glioma synapses (AMPA)","x":75,"y":25},{"id":"growth","label":"Growth, invasion, immunosuppression","x":92,"y":50}],"edges":[{"from":"tum","to":"ngf","type":"activates"},{"from":"ngf","to":"nerve","type":"activates"},{"from":"nerve","to":"adr","type":"activates"},{"from":"adr","to":"growth","type":"activates"},{"from":"syn","to":"growth","type":"activates"},{"from":"tum","to":"syn","type":"activates"}],"interventions":["Propranolol and other β-blockers in trials (melanoma, breast, angiosarcoma)","Botulinum toxin denervation trials (gastric)","NGF/TrkA and AMPA-receptor (perampanel) blockade; gabapentin in glioma trials","Perineural invasion as a staging biomarker"]},"route":"/pathways/cancer-neuroscience/","neighbours":{"cancer":[{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"},{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"},{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"target":[{"id":"ntrk","kind":"target","name":"NTRK","route":"/targets/ntrk/"}],"institution":[{"id":"md-anderson","kind":"institution","name":"MD Anderson Cancer Center","route":"/institutions/md-anderson/"},{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"},{"id":"stanford","kind":"institution","name":"Stanford Health Care / Stanford Cancer Institute","route":"/institutions/stanford/"}],"pathway":[{"id":"blood-brain-barrier-metastasis","kind":"pathway","name":"The blood-brain barrier & brain metastasis","route":"/pathways/blood-brain-barrier-metastasis/"},{"id":"metastatic-cascade","kind":"pathway","name":"The metastatic cascade","route":"/pathways/metastatic-cascade/"},{"id":"tumor-microenvironment","kind":"pathway","name":"Tumour microenvironment (TME)","route":"/pathways/tumor-microenvironment/"}],"paper":[{"id":"paper-venkatesh-nature","kind":"paper","name":"Electrical and synaptic integration of glioma into neural circuits","route":"/key-papers/paper-venkatesh-nature/"},{"id":"paper-monje-cell","kind":"paper","name":"Roadmap for the Emerging Field of Cancer Neuroscience","route":"/key-papers/paper-monje-cell/"}],"idea":[{"id":"idea-nerve-tumour-blockade","kind":"idea","name":"Cut the nerve supply to tumours with old drugs","route":"/ideas/idea-nerve-tumour-blockade/"}],"roadmap":[{"id":"cure-paths","kind":"roadmap","name":"Paths to cures: interception, eradication, control","route":"/roadmaps/cure-paths/"},{"id":"frontier-2035","kind":"roadmap","name":"Radical oncology: what could change the war by 2035","route":"/roadmaps/frontier-2035/"}],"term":[{"id":"bioelectric-theory-of-cancer","kind":"term","name":"Bioelectric theory of cancer (Levin)","route":"/terms/bioelectric-theory-of-cancer/"}]}}