{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:51:22Z","timestamp":1791265882386,"version":"4.1.0"},"reference-count":80,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>High\u2010grade gliomas (HGGs), particularly glioblastoma (GBM), remain among the most lethal human cancers despite decades of molecular profiling and therapeutic innovation. A primary reason for treatment failure is that HGG biology is spatial: malignant cell states, immune suppression, metabolic stress, and therapeutic resistance are organized into distinct anatomical and functional niches. Spatial omics technologies now enable high\u2010dimensional mapping of gene expression, protein signaling, immune architecture, and metabolic activity within intact tumor tissue. These approaches reveal how proneural and mesenchymal transcriptional states coexist yet localize to distinct regions, alongside hypoxic, invasive, and stem\u2010enriched niches. Spatial analyses show that key clinical determinants, including O6\u2010methylguanine\u2010DNA methyltransferase (MGMT)\u2010associated temozolomide resistance, radiotherapy tolerance in hypoxic regions, and immunotherapy failure driven by myeloid\u2010dominated immune exclusion, are influenced not only by molecular programs but also by cellular location. Beyond biological insight, spatial omics is reshaping clinical paradigms by enabling region\u2010specific patient stratification, early assessment of treatment response, and identification of therapy\u2010resistant reservoirs that seed recurrence. Prior bulk and single\u2010cell studies defined HGG cell states and pathways but often treated resistance as tumor\u2010wide. This review presents a spatially explicit framework that synthesizes spatial transcriptomic and immune\u2010profiling studies to identify tumor\u2013immune niches and spatial bottlenecks that drive therapeutic failure and recurrence.<\/jats:p>","DOI":"10.1002\/cam4.72238","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:13:27Z","timestamp":1789020807000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatial Omics in High\u2010Grade Gliomas: Mapping Immune\u2013Tumor Niches for Precision Therapy"],"prefix":"10.1002","volume":"15","author":[{"given":"Saniyah","family":"Shaikh","sequence":"first","affiliation":[{"name":"College of Medicine Alfaisal University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaabit","family":"Raziq","sequence":"additional","affiliation":[{"name":"College of Medicine Alfaisal University  Riyadh Saudi 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