The most prevalent primary brain tumor, glioblastoma, ranks among the most lethal of human cancers. The brain
tumor microenvironment (TME) is thought to play a critical role during tumor development and treatment
resistance. Unlike many other solid tumors, the glioblastoma TME is dominated by macrophages and microglia—
collectively known as tumor-associated macrophages (TAMs). TAMs are plastic in nature and can polarize
toward pro-inflammatory or immunosuppressive states. Many lines of evidence suggest that immunosuppressive
TAMs dominate the brain tumor microenvironment, which fosters tumor development, contributes to tumor
aggressiveness, and impedes the therapeutic effect of various treatment regimens. Through the development of
new therapeutic strategies, TAMs can potentially be shifted towards a proinflammatory state to enhance anti-
tumor immunity. The promise of TAM-targeted therapy has not yet been realized, due in part to a limited
understanding of the molecular mechanisms underlying TAM behavior and function. My postdoctoral work has
elucidated novel mechanisms that govern the polarization of TAMs in the glioblastoma TME. Notably, my
preliminary data suggests that targeting the CARD9/BCL10/MALT1 (CBM) signaling complex represents a
promising therapeutic approach to shifting the glioblastoma TAM phenotype to favor anti-tumor immunity.
The overall objectives of this application are to determine the molecular mechanisms that regulate TAM
immunoreactivity in glioblastoma and to utilize this information to inform the development of new and effective
therapeutic interventions to improve treatment outcomes. My central hypothesis is that CBM activation within
TAMs is required for glioblastoma-induced TAM polarization toward an immunosuppressive phenotype and this
CBM-dependent TAM polarization facilitates tumor growth, progression, and resistance to therapy. I first propose
to elucidate the molecular mechanisms by which glioblastoma cells communicate with TAMs to drive CBM
activation (Aim 1). Second, I will evaluate how CBM activity within TAMs influences TAM function (Aim 2).
Finally, during the R00 phase of this proposal I will investigate how inhibiting the CARD9-CBM complex in TAMs
in vivo affects glioblastoma tumor progression and responsiveness to standard therapies (Aim 3). Collectively,
these studies will advance our understanding of the mechanisms governing the brain tumor immune
microenvironment of glioblastoma and inform the development of new approaches to manipulating this immune
microenvironment to improve treatment outcomes for glioblastoma. During the mentored K99 phase of this
award, I will greatly benefit from the expert mentoring world-class research resources available at the University
of Pittsburgh and the UPMC Hillman Cancer Center. Completing the proposed project will allow me to build a
strong scientific foundation and then lead an innovative research program as an independent investigator.
Overall, the K99/R00 award will be an indispensable support for my timely transition to a successful career as a
multifaceted, cross-disciplinary investigator in neuro-oncology.