World Neurosurg
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Glioblastoma (GBM) is the most aggressive primary tumor of the central nervous system. Despite aggressive multimodal therapy, it has a dismal prognosis. Over the last 20 years, the approach to GBM research and therapy has involved viewing the pathologic condition as a complex organ system with multiple nonneoplastic cells supporting tumor growth directly or through enhancement of the tumor microenvironment. ⋯ Clinical trials targeting PD-L-1, CTLA-4, and colony stimulating factor-1 receptor in GBM are currently under investigation. Additionally, several phase I/II clinical trials are underway using vaccines, oncolytic viruses, antibodies, and chimeric antigen receptor T cells targeting glioma cells. Co-opting the immune system as a therapeutic partner against GBM is in early stages of investigation, and the potential use of such approaches as treatment adjuncts is indispensable for combating this highly heterogeneous disease.
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Women have been a minority in neurosurgery since the foundation of the specialty. Women who choose to pursue neurosurgery or advance in their career must overcome various obstacles. In this article, we discuss the proportion of women in neurosurgery globally and the obstacles they face, as well as the solutions being implemented. ⋯ With the shortage of neurosurgeons in many regions of the world, the recruitment of female neurosurgeons plays a vital role in meeting those demands. Our cultures and professional societies should celebrate their inclusion and promotion and accommodate the complex role of women as neurosurgeons, mothers, partners, scientists, and leaders.