Genomic alterations and treatment define spatiotemporal patterns of glioblastoma recurrence.

Genomic context and treatment exposure define distinct glioblastoma recurrence trajectories, with TP53 mutations linked to early recurrence and resistance.

• Why it matters: Understanding the molecular features of glioblastoma recurrence at the surgical margin is crucial for improving treatment strategies and patient outcomes, yet these features are poorly characterized.
• What they did: Researchers performed histology-guided sampling and single-cell spatial transcriptomics on primary, margin, and recurrent tumor regions from 40 patients, identifying molecular subtypes and mutation patterns associated with recurrence.
• The result: Findings show that TP53 mutations and sustained proliferation are linked to early recurrence and shorter survival, while TP53-wild-type tumors tend to transition toward the mesenchymal subtype with increased p53 activity, suggesting genomic context influences recurrence pathways.