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Hsieh AL, Bi WL, Ramesh V, Brastianos PK, Plotkin SR. Evolving concepts in meningioma management in the era of genomics. Cancer 2024; 130:2586-2600. [PMID: 38753473 PMCID: PMC11260245 DOI: 10.1002/cncr.35279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 05/18/2024]
Abstract
Meningioma is the most common type of primary brain tumor. Surgical resection followed by surveillance is the first-line treatment for the majority of symptomatic meningiomas; however, recent advances in molecular sequencing, DNA methylation, proteomics, and single-cell sequencing provide insights into further characterizing this heterogeneous group of tumors with a wide range of prognoses. A subset of these tumors are highly aggressive and cause severe morbidity and mortality. Therefore, identifying those individuals with a poor prognosis and intervening are critical. This review aims to help readers interpret the molecular profiling of meningiomas to identify patients with worse prognoses and guide the management and strategy for surveillance.
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Affiliation(s)
- Annie L. Hsieh
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vijaya Ramesh
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Priscilla K Brastianos
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Central Nervous System Metastasis Program, Massachusetts General Hospital, Boston, MA, United States
- Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott R. Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Wu Y, Wang X, Zhang M, Wu D. Molecular Biomarkers and Recent Liquid Biopsy Testing Progress: A Review of the Application of Biosensors for the Diagnosis of Gliomas. Molecules 2023; 28:5660. [PMID: 37570630 PMCID: PMC10419986 DOI: 10.3390/molecules28155660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Gliomas are the most common primary central nervous system tumors, with a high mortality rate. Early and accurate diagnosis of gliomas is critical for successful treatment. Biosensors are significant in the detection of molecular biomarkers because they are simple to use, portable, and capable of real-time analysis. This review discusses several important molecular biomarkers as well as various biosensors designed for glioma diagnosis, such as electrochemical biosensors and optical biosensors. We present our perspectives on the existing challenges and hope that this review can promote the improvement of biosensors.
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Affiliation(s)
- Yuanbin Wu
- Department of Emergency Medicine, The Seventh Medical Center, Chinese PLA General Hospital, Beijing 100700, China;
| | - Xuning Wang
- Department of General Surgery, The Air Force Hospital of Northern Theater PLA, Shenyang 110042, China
| | - Meng Zhang
- Department of Neurosurgery, The Second Hospital of Southern Theater of Chinese Navy, Sanya 572000, China
| | - Dongdong Wu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
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Kannapadi NV, Shah PP, Mathios D, Jackson CM. Synthesizing Molecular and Immune Characteristics to Move Beyond WHO Grade in Meningiomas: A Focused Review. Front Oncol 2022; 12:892004. [PMID: 35712492 PMCID: PMC9194503 DOI: 10.3389/fonc.2022.892004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022] Open
Abstract
No portion of this manuscript has previously been presented. Meningiomas, the most common primary intracranial tumors, are histologically categorized by the World Health Organization (WHO) grading system. While higher WHO grade is generally associated with poor clinical outcomes, a significant subset of grade I tumors recur or progress, indicating a need for more reliable models of meningioma behavior. Several groups have developed risk scores based on molecular or immunologic characteristics. These classification schemes show promise, with several models preliminarily demonstrating similar or superior accuracy to WHO grading. Improved understanding of immune system recognition and targeting of meningioma subtypes is necessary to advance the predictive power, as well as develop new therapies. Here, we characterize meningioma molecular drivers, predictive of recurrence and progression, and describe specific aspects of the immune response to meningiomas while highlighting critical questions and ongoing research. Relevant manuscripts of interest were identified using a systematic approach and synthesized into this focused review. Finally, we summarize the ongoing and completed clinical trials for immunotherapy in meningiomas and offer perspective on future directions.
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Affiliation(s)
- Nivedha V Kannapadi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Pavan P Shah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dimitrios Mathios
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christopher M Jackson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Park YW, Kim D, Eom J, Ahn SS, Moon JH, Kim EH, Kang SG, Chang JH, Kim SH, Lee SK. A diagnostic tree for differentiation of adult pilocytic astrocytomas from high-grade gliomas. Eur J Radiol 2021; 143:109946. [PMID: 34534909 DOI: 10.1016/j.ejrad.2021.109946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND To develop a diagnostic tree analysis (DTA) model based on demographical information and conventional MRI for differential diagnosis of adult pilocytic astrocytomas (PAs) and high-grade gliomas (HGGs; World Health Organization grade III-IV). METHODS A total of 357 adult patients with pathologically confirmed PA (n = 65) and HGGs (n = 292) who underwent conventional MRI were included. The patients were randomly divided into training (n = 250) and validation (n = 107) datasets to assess the diagnostic performance of the DTA model. The DTA model was created using a classification and regression tree algorithm on the basis of demographical and MRI findings. RESULTS In the DTA model, tumor location (on cerebellum, brainstem, hypothalamus, optic nerve, or ventricle), cystic mass with mural nodule appearance, presence of infiltrative growth, and major axis (cutoff value, 2.9 cm) were significant predictors for differential diagnosis of adult PAs and HGGs. The AUC, accuracy, sensitivity, and specificity were 0.94 (95% confidence interval 0.86-1.00), 96.2%, 89.5%, and 97.7%, respectively, in the test set. The accuracy of the DTA model was significantly higher than the no-information rate in the test (96.2 % vs 85.0%, P < 0.001) set. CONCLUSION The DTA model based on MRI findings may be useful for differential diagnosis of adult PA and HGGs.
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Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dain Kim
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Jihwan Eom
- Department of Computer Science, Yonsei University, Seoul, Republic of Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Ju Hyung Moon
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eui Hyun Kim
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok-Gu Kang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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Tatman PD, Wroblewski TH, Fringuello AR, Scherer SR, Foreman WB, Damek DM, Lillehei K, Youssef AS, Jensen RL, Graner MW, Ormond DR. High-Throughput Mechanistic Screening of Epigenetic Compounds for the Potential Treatment of Meningiomas. J Clin Med 2021; 10:jcm10143150. [PMID: 34300316 PMCID: PMC8303324 DOI: 10.3390/jcm10143150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Meningiomas are the most common primary central nervous system tumors. 20–30% of these tumors are considered high-grade and associated with poor prognosis and high recurrence rates. Despite the high occurrence of meningiomas, there are no FDA-approved compounds for the treatment of these tumors. Methods: In this study, we screened patient-cultured meningiomas with an epigenetic compound library to identify targetable mechanisms for the potential treatment of these tumors. Meningioma cell cultures were generated directly from surgically resected patient tumors and were cultured on a neural matrix. Cells were treated with a library of compounds meant to target epigenetic functions. Results: Although each tumor displayed a unique compound sensitivity profile, Panobinostat, LAQ824, and HC toxin were broadly effective across most tumors. These three compounds are broad-spectrum Histone Deacetylase (HDAC) inhibitors which target class I, IIa, and IIb HDACs. Panobinostat was identified as the most broadly effective compound, capable of significantly decreasing the average cell viability of the sample cohort, regardless of tumor grade, recurrence, radiation, and patient gender. Conclusions: These findings strongly suggest an important role of HDACs in meningioma biology and as a targetable mechanism. Additional validation studies are necessary to confirm these promising findings, as well to identify an ideal HDAC inhibitor candidate to develop for clinical use.
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Affiliation(s)
- Philip D. Tatman
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Medical Scientist Training Program, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
- Department of Pharmacology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Tadeusz H. Wroblewski
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Anthony R. Fringuello
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - Samuel R. Scherer
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - William B. Foreman
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Denise M. Damek
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Kevin Lillehei
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - A. Samy Youssef
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - Randy L. Jensen
- Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
| | - Michael W. Graner
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Correspondence: (M.W.G.); (D.R.O.)
| | - D. Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Correspondence: (M.W.G.); (D.R.O.)
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