Cancer cell heterogeneity and plasticity: A paradigm shift in glioblastoma

Yahaya A. Yabo, Simone P. Niclou, Anna Golebiewska*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

45 Citations (Scopus)


Phenotypic plasticity has emerged as a major contributor to intra-tumoral heterogeneity and treatment resistance in cancer. Increasing evidence shows that glioblastoma (GBM) cells display prominent intrinsic plasticity and reversibly adapt to dynamic microenvironmental conditions. Limited genetic evolution at recurrence further suggests that resistance mechanisms also largely operate at the phenotypic level. Here we review recent literature underpinning the role of GBM plasticity in creating gradients of heterogeneous cells including those that carry cancer stem cell (CSC) properties. A historical perspective from the hierarchical to the nonhierarchical concept of CSCs towards the recent appreciation of GBM plasticity is provided. Cellular states interact dynamically with each other and with the surrounding brain to shape a flexible tumor ecosystem, which enables swift adaptation to external pressure including treatment. We present the key components regulating intra-tumoral phenotypic heterogeneity and the equilibrium of phenotypic states, including genetic, epigenetic, and microenvironmental factors. We further discuss plasticity in the context of intrinsic tumor resistance, where a variable balance between preexisting resistant cells and adaptive persisters leads to reversible adaptation upon treatment. Innovative efforts targeting regulators of plasticity and mechanisms of state transitions towards treatment-resistant states are needed to restrict the adaptive capacities of GBM.

Original languageEnglish
Pages (from-to)669-682
Number of pages14
Issue number5
Early online date21 Dec 2021
Publication statusPublished - 4 May 2022


  • glioblastoma
  • plasticity
  • treatment resistance
  • tumor heterogeneity
  • tumor microenvironment


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