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Na J, Shaji S, Hanemann CO. Targeting histone deacetylase 6 (HDAC6) to enhance radiation therapy in meningiomas in a 2D and 3D in vitro study. EBioMedicine 2024; 105:105211. [PMID: 38917510 PMCID: PMC11255518 DOI: 10.1016/j.ebiom.2024.105211] [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: 09/28/2023] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND External radiation therapy (RT) is often a primary treatment for inoperable meningiomas in the absence of established chemotherapy. Histone deacetylase 6 (HDAC6) overexpression, commonly found in cancer, is acknowledged as a driver of cellular growth, and inhibiting HDACs holds promise in improving radiotherapeutic efficacy. Downregulation of HDAC6 facilitates the degradation of β-catenin. This protein is a key element in the Wnt/β-catenin signalling pathway, contributing to the progression of meningiomas. METHODS In order to elucidate the associations and therapeutic potential of HDAC6 inhibitors (HDAC6i) in conjunction with RT, we administered Cay10603, HDAC6i, to both immortalised and patient-derived meningioma cells prior to RT in this study. FINDINGS Our findings reveal an increase in HDAC6 expression following exposure to RT, which is effectively mitigated with pre-treated Cay10603. The combination of Cay10603 with RT resulted in a synergistic augmentation of cytotoxic effects, as demonstrated through a range of functional assays conducted in both 2D as well as 3D settings; the latter containing syngeneic tumour microenvironment (TME). Radiation-induced DNA damage was augmented by pre-treatment with Cay10603, concomitant with the inhibition of β-catenin and minichromosome maintenance complex component 2 (MCM2) accumulation within the nucleus. This subsequently inhibited c-myc oncogene expression. INTERPRETATION Our findings demonstrate the therapeutic potential of Cay10603 to improve the radiosensitisation and provide rationale for combining HDAC6i with RT for the treatment of meningioma. FUNDING This work was funded by Brain Tumour Research Centre of Excellence award to C Oliver Hanemann.
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Affiliation(s)
- Juri Na
- Peninsula Medical School, Faculty of Health, University of Plymouth, Devon, United Kingdom
| | - Shahana Shaji
- Peninsula Medical School, Faculty of Health, University of Plymouth, Devon, United Kingdom
| | - C Oliver Hanemann
- Peninsula Medical School, Faculty of Health, University of Plymouth, Devon, United Kingdom.
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2
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Purohit P, Mittal BR, Kumar R, Singh H, Shukla J, Bal A, Singh N. 68 Ga-FAPI PET/CT in an Interesting Case of Metastatic Pulmonary Meningioma. Clin Nucl Med 2024; 49:e269-e271. [PMID: 38537208 DOI: 10.1097/rlu.0000000000005161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Meningiomas are one of the major primary CNS tumors. Most meningiomas are benign, but rarely, these metastasize to distant organs, the lungs being the commonest site of metastasis. 18 F-FDG PET/CT has been used to evaluate metastatic pulmonary meningioma. However, 68 Ga-FAPI PET/CT has not yet been evaluated. The present case highlights the 68 Ga-FAPI uptake in metastatic pulmonary meningioma in a postoperated case of left tentorial meningioma presenting with lung masses. Image-guided biopsy from the lung mass was consistent with metastatic meningioma.
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Affiliation(s)
| | | | | | | | | | | | - Navneet Singh
- Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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3
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Zakimi N, Nguyen MP, Raleigh DR. Gene transcript fusions are associated with clinical outcomes and molecular groups of meningiomas. Acta Neuropathol 2024; 147:57. [PMID: 38509407 PMCID: PMC10954959 DOI: 10.1007/s00401-024-02708-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Naomi Zakimi
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Minh P Nguyen
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - David R Raleigh
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA.
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4
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Staedtke V, Anstett K, Bedwell D, Giovannini M, Keeling K, Kesterson R, Kim Y, Korf B, Leier A, McManus ML, Sarnoff H, Vitte J, Walker JA, Plotkin SR, Wallis D. Gene-targeted therapy for neurofibromatosis and schwannomatosis: The path to clinical trials. Clin Trials 2024; 21:51-66. [PMID: 37937606 DOI: 10.1177/17407745231207970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Numerous successful gene-targeted therapies are arising for the treatment of a variety of rare diseases. At the same time, current treatment options for neurofibromatosis 1 and schwannomatosis are limited and do not directly address loss of gene/protein function. In addition, treatments have mostly focused on symptomatic tumors, but have failed to address multisystem involvement in these conditions. Gene-targeted therapies hold promise to address these limitations. However, despite intense interest over decades, multiple preclinical and clinical issues need to be resolved before they become a reality. The optimal approaches to gene-, mRNA-, or protein restoration and to delivery to the appropriate cell types remain elusive. Preclinical models that recapitulate manifestations of neurofibromatosis 1 and schwannomatosis need to be refined. The development of validated assays for measuring neurofibromin and merlin activity in animal and human tissues will be critical for early-stage trials, as will the selection of appropriate patients, based on their individual genotypes and risk/benefit balance. Once the safety of gene-targeted therapy for symptomatic tumors has been established, the possibility of addressing a wide range of symptoms, including non-tumor manifestations, should be explored. As preclinical efforts are underway, it will be essential to educate both clinicians and those affected by neurofibromatosis 1/schwannomatosis about the risks and benefits of gene-targeted therapy for these conditions.
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Affiliation(s)
- Verena Staedtke
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Kara Anstett
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - David Bedwell
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marco Giovannini
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA and Jonsson Comprehensive Cancer Center (JCCC), University of California Los Angeles, Los Angeles, CA, USA
| | - Kim Keeling
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert Kesterson
- Department of Cancer Precision Medicine, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - YooRi Kim
- Gilbert Family Foundation, Detroit, MI, USA
| | - Bruce Korf
- Department of Genetics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - André Leier
- Department of Genetics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Jeremie Vitte
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA and Jonsson Comprehensive Cancer Center (JCCC), University of California Los Angeles, Los Angeles, CA, USA
| | - James A Walker
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Scott R Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Deeann Wallis
- Department of Genetics, The University of Alabama at Birmingham, Birmingham, AL, USA
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5
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Ahmed AK, Wilhelmy B, Oliver J, Serra R, Chen C, Gandhi D, Eisenberg HM, Labib MA, Woodworth GF. Variability in the Arterial Supply of Intracranial Meningiomas: An Anatomic Study. Neurosurgery 2023; 93:1346-1352. [PMID: 37530524 DOI: 10.1227/neu.0000000000002608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/14/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Intracranial meningiomas are a diverse group of tumors, which vary by grade, genetic composition, location, and vasculature. Expanding the understanding of the supply of skull base (SBMs) and non-skull base meningiomas (NSBMs) will serve to further inform resection strategies. We sought to delineate the vascular supply of a series of intracranial meningiomas by tumor location. METHODS A retrospective study of intracranial meningiomas that were studied using preoperative digital subtraction angiograms before surgical resection at a tertiary referral center was performed. Patient, tumor, radiologic, and treatment data were collected, and regression models were developed. RESULTS One hundred sixty-five patients met inclusion criteria. The mean age was 57.1 years (SD: 12.6). The mean tumor diameter was 4.9 cm (SD: 1.5). One hundred twenty-six were World Health Organization Grade I, 37 Grade II, and 2 Grade III. Arterial feeders were tabulated by Al-Mefty's anatomic designations. SBMs were more likely to derive arterial supply from the anterior circulation, whereas NSBMs were supplied by external carotid branches. NSBMs were larger (5.61 cm vs 4.45 cm, P = <.001), were more often presented with seizure (20% vs 8%, P = .03), were higher grade ( P = <.001) had more frequent peritumoral brain edema (84.6% vs 66%, P = .04), and had more bilateral feeders (47.7% vs 28%, P = .01) compared with SBMs. More arterial feeders were significantly associated with lower tumor grade ( P = .023, OR = 0.59). Higher tumor grade (Grade II/III) was associated with fewer arterial feeders ( P = .017, RR = 0.74). CONCLUSION Meningioma location is associated with specific vascular supply patterns, grade, and patient outcomes. This information suggests that grade I tumors, especially larger tumors, are more likely to have diverse vascular supply patterns, including internal carotid branches. This study may inform preoperative embolization and surgical considerations, particularly for large skull base tumors.
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Affiliation(s)
- Abdul-Kareem Ahmed
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Bradley Wilhelmy
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Jeffrey Oliver
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Riccardo Serra
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Chixiang Chen
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Dheeraj Gandhi
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Howard M Eisenberg
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Mohamed A Labib
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Graeme F Woodworth
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
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Andersen MS, Kofoed MS, Paludan-Müller AS, Pedersen CB, Mathiesen T, Mawrin C, Wirenfeldt M, Kristensen BW, Olsen BB, Halle B, Poulsen FR. Meningioma animal models: a systematic review and meta-analysis. J Transl Med 2023; 21:764. [PMID: 37898750 PMCID: PMC10612271 DOI: 10.1186/s12967-023-04620-7] [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: 07/25/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Animal models are widely used to study pathological processes and drug (side) effects in a controlled environment. There is a wide variety of methods available for establishing animal models depending on the research question. Commonly used methods in tumor research include xenografting cells (established/commercially available or primary patient-derived) or whole tumor pieces either orthotopically or heterotopically and the more recent genetically engineered models-each type with their own advantages and disadvantages. The current systematic review aimed to investigate the meningioma model types used, perform a meta-analysis on tumor take rate (TTR), and perform critical appraisal of the included studies. The study also aimed to assess reproducibility, reliability, means of validation and verification of models, alongside pros and cons and uses of the model types. METHODS We searched Medline, Embase, and Web of Science for all in vivo meningioma models. The primary outcome was tumor take rate. Meta-analysis was performed on tumor take rate followed by subgroup analyses on the number of cells and duration of incubation. The validity of the tumor models was assessed qualitatively. We performed critical appraisal of the methodological quality and quality of reporting for all included studies. RESULTS We included 114 unique records (78 using established cell line models (ECLM), 21 using primary patient-derived tumor models (PTM), 10 using genetically engineered models (GEM), and 11 using uncategorized models). TTRs for ECLM were 94% (95% CI 92-96) for orthotopic and 95% (93-96) for heterotopic. PTM showed lower TTRs [orthotopic 53% (33-72) and heterotopic 82% (73-89)] and finally GEM revealed a TTR of 34% (26-43). CONCLUSION This systematic review shows high consistent TTRs in established cell line models and varying TTRs in primary patient-derived models and genetically engineered models. However, we identified several issues regarding the quality of reporting and the methodological approach that reduce the validity, transparency, and reproducibility of studies and suggest a high risk of publication bias. Finally, each tumor model type has specific roles in research based on their advantages (and disadvantages). SYSTEMATIC REVIEW REGISTRATION PROSPERO-ID CRD42022308833.
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Affiliation(s)
- Mikkel Schou Andersen
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark.
- BRIDGE (Brain Research - Inter Disciplinary Guided Excellence), University of Southern Denmark, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Mikkel Seremet Kofoed
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
- BRIDGE (Brain Research - Inter Disciplinary Guided Excellence), University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Asger Sand Paludan-Müller
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
- Centre for Evidence-Based Medicine Odense (CEBMO) and NHTA: Market Access & Health Economics Consultancy, Copenhagen, Denmark
| | - Christian Bonde Pedersen
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
- BRIDGE (Brain Research - Inter Disciplinary Guided Excellence), University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Tiit Mathiesen
- Department of Neurosurgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Christian Mawrin
- Department of Neuropathology, Otto-Von-Guericke University, Magdeburg, Germany
| | - Martin Wirenfeldt
- Department of Pathology and Molecular Biology, Hospital South West Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern, Odense, Denmark
| | | | - Birgitte Brinkmann Olsen
- Clinical Physiology and Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - Bo Halle
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
- BRIDGE (Brain Research - Inter Disciplinary Guided Excellence), University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Frantz Rom Poulsen
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
- BRIDGE (Brain Research - Inter Disciplinary Guided Excellence), University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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7
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Himič V, Burman RJ, Fountain DM, Hofer M, Livermore LJ, Jeyaretna DS. Metastatic meningioma: a case series and systematic review. Acta Neurochir (Wien) 2023; 165:2873-2883. [PMID: 37491650 PMCID: PMC10542723 DOI: 10.1007/s00701-023-05687-3] [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: 05/09/2023] [Accepted: 06/15/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Meningiomas are the most common primary intracranial tumor. While the majority of meningiomas are benign, rarely they can metastasize extracranially. There is a need for a more comprehensive review of these patients to improve our understanding of this rare phenomenon and its prevalence globally. Here we describe our institution's experience of patients presenting with metastatic meningiomas. We further perform a systematic review of the existing literature to explore common features of this rare manifestation of meningioma and review the efficacy of current treatments. METHODS We performed a retrospective clinical review of all adult patients with metastatic meningioma managed at our institution over the past 20 years, identifying 6 patients. We then performed a systematic review of cases of metastatic meningioma in the literature ranging from the years 1886 to 2022. A descriptive analysis was then conducted on the available data from 1979 onward, focusing on the grade and location of the primary tumor as well as the latency period to, and location of, the metastasis. RESULTS In total, we analyzed 155 cases. Fifty-four percent of patients initially presented with a primary meningioma located in the convexity. The most common site of metastasis was the lung. Risk factors associated with a shorter time to metastasis were male sex and a high initial grade of the tumor. Regarding treatment, the addition of chemotherapy was the most common adjunct to the standard management of surgery and radiotherapy. Despite an exhaustive review we were unable to identify effective treatments. The majority of published cases came from centers situated in high-income countries (84%) while only 16% came from lower- and middle-income countries. CONCLUSIONS Metastatic meningiomas pose a pertinent, and likely underestimated, clinical challenge within modern neurosurgery. To optimize management, timely identification of these patients is important. More research is needed to explore the mechanisms underlying these tumors to better guide the development of effective screening and management protocols. However, screening of each meningioma patient is not feasible, and at the heart of this challenge is the inability to control the primary disease. Ultimately, a consensus is needed as to how to correctly screen for and manage these patients; genomic and epigenomic approaches could hold the answer to finding druggable targets.
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Affiliation(s)
- Vratko Himič
- Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Richard J Burman
- Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Daniel M Fountain
- Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Monika Hofer
- Department of Neuropathology, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Laurent J Livermore
- Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - D Sanjeeva Jeyaretna
- Department of Neurosurgery, John Radcliffe Hospital, University of Oxford, Oxford, UK.
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
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Fountain DM, Sauka-Spengler T. The SWI/SNF Complex in Neural Crest Cell Development and Disease. Annu Rev Genomics Hum Genet 2023; 24:203-223. [PMID: 37624665 DOI: 10.1146/annurev-genom-011723-082913] [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] [Indexed: 08/27/2023]
Abstract
While the neural crest cell population gives rise to an extraordinary array of derivatives, including elements of the craniofacial skeleton, skin pigmentation, and peripheral nervous system, it is today increasingly recognized that Schwann cell precursors are also multipotent. Two mammalian paralogs of the SWI/SNF (switch/sucrose nonfermentable) chromatin-remodeling complexes, BAF (Brg1-associated factors) and PBAF (polybromo-associated BAF), are critical for neural crest specification during normal mammalian development. There is increasing evidence that pathogenic variants in components of the BAF and PBAF complexes play central roles in the pathogenesis of neural crest-derived tumors. Transgenic mouse models demonstrate a temporal window early in development where pathogenic variants in Smarcb1 result in the formation of aggressive, poorly differentiated tumors, such as rhabdoid tumors. By contrast, later in development, homozygous inactivation of Smarcb1 requires additional pathogenic variants in tumor suppressor genes to drive the development of differentiated adult neoplasms derived from the neural crest, which have a comparatively good prognosis in humans.
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Affiliation(s)
- Daniel M Fountain
- MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom; ,
| | - Tatjana Sauka-Spengler
- MRC Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom; ,
- Stowers Institute for Medical Research, Kansas City, Missouri, USA
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9
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Cômes PC, Le Van T, Tran S, Huard S, Abi-Jaoude S, Venot Q, Marijon P, Boetto J, Blouin A, Bielle F, Ducos Y, Teranishi Y, Kalamarides M, Peyre M. Respective roles of Pik3ca mutations and cyproterone acetate impregnation in mouse meningioma tumorigenesis. Cancer Gene Ther 2023; 30:1114-1123. [PMID: 37188724 DOI: 10.1038/s41417-023-00621-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/05/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
Despite their rarity, PIK3CA mutations in meningiomas have raised interest as potentially targetable, ubiquitous mutations owing to their presence in sporadic benign and malignant tumors but also in hormone-related cases. Using new genetically engineered mouse models, we here demonstrate that Pik3ca mutations in postnatal meningeal cells are sufficient to promote meningioma formation but also tumor progression in mice. Conversely, hormone impregnation, whether alone or in association with Pik3ca and Nf2 mutations, fails to induce meningioma tumorigenesis while promoting breast tumor formation. We then confirm in vitro the effect of Pik3ca mutations but not hormone impregnation on the proliferation of primary cultures of mouse meningeal cells. Finally, we show by exome analysis of breast tumors and meninges that hormone impregnation promotes breast tumor formation without additional somatic oncogenic mutation but is associated with an increased mutational burden on Pik3ca-mutant background. Taken together, these results tend to suggest a prominent role of Pik3ca mutations over hormone impregnation in meningioma tumorigenesis, the exact effect of the latter is still to be discovered.
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Affiliation(s)
- Pierre-Cyril Cômes
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Tuan Le Van
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Suzanne Tran
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
- Department of Neuropathology, AP-HP, Hôpital Pitié Salpétrière, Paris, 75013, France
| | - Solène Huard
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Samiya Abi-Jaoude
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Quitterie Venot
- Université de Paris, Paris, 75006, France
- INSERM U1151, Institut Necker-Enfants Malades, Paris, 75015, France
| | - Pauline Marijon
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
- Department of Neurosurgery, AP-HP, Hôpital Pitié-Salpêtrière, Paris, 75013, France
| | - Julien Boetto
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Antoine Blouin
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Franck Bielle
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
- Department of Neuropathology, AP-HP, Hôpital Pitié Salpétrière, Paris, 75013, France
| | - Yohan Ducos
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Yu Teranishi
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
| | - Michel Kalamarides
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France
- Department of Neurosurgery, AP-HP, Hôpital Pitié-Salpêtrière, Paris, 75013, France
| | - Matthieu Peyre
- Sorbonne Université, CRICM INSERM U1127 CNRS UMR 7225, Paris Brain Institute, Paris, 75013, France.
- Department of Neurosurgery, AP-HP, Hôpital Pitié-Salpêtrière, Paris, 75013, France.
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Choudhury A, Cady MA, Lucas CHG, Najem H, Phillips JJ, Palikuqi B, Zakimi N, Joseph T, Birrueta JO, Chen WC, Bush NAO, Hervey-Jumper SL, Klein OD, Toedebusch CM, Horbinski CM, Magill ST, Bhaduri A, Perry A, Dickinson PJ, Heimberger AB, Ashworth A, Crouch EE, Raleigh DR. NOTCH3 drives meningioma tumorigenesis and resistance to radiotherapy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.10.548456. [PMID: 37503127 PMCID: PMC10369862 DOI: 10.1101/2023.07.10.548456] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Meningiomas are the most common primary intracranial tumors1-3. Treatments for patients with meningiomas are limited to surgery and radiotherapy, and systemic therapies remain ineffective or experimental4,5. Resistance to radiotherapy is common in high-grade meningiomas6, and the cell types and signaling mechanisms driving meningioma tumorigenesis or resistance to radiotherapy are incompletely understood. Here we report NOTCH3 drives meningioma tumorigenesis and resistance to radiotherapy and find NOTCH3+ meningioma mural cells are conserved across meningiomas from humans, dogs, and mice. NOTCH3+ cells are restricted to the perivascular niche during meningeal development and homeostasis and in low-grade meningiomas but are expressed throughout high-grade meningiomas that are resistant to radiotherapy. Integrating single-cell transcriptomics with lineage tracing and imaging approaches across mouse genetic and xenograft models, we show NOTCH3 drives tumor initiating capacity, cell proliferation, angiogenesis, and resistance to radiotherapy to increase meningioma growth and reduce survival. An antibody stabilizing the extracellular negative regulatory region of NOTCH37,8 blocks meningioma tumorigenesis and sensitizes meningiomas to radiotherapy, reducing tumor growth and improving survival in preclinical models. In summary, our results identify a conserved cell type and signaling mechanism that underlie meningioma tumorigenesis and resistance to radiotherapy, revealing a new therapeutic vulnerability to treat meningiomas that are resistant to standard interventions.
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Affiliation(s)
- Abrar Choudhury
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
- Medical Scientist Training Program, University of California San Francisco, San Francisco, CA, USA
| | - Martha A. Cady
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
- Tetrad Graduate Program, University of California, San Francisco, San Francisco, CA, USA
| | - Calixto-Hope G. Lucas
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Hinda Najem
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Joanna J. Phillips
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Brisa Palikuqi
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Naomi Zakimi
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Tara Joseph
- Department of Pediatrics, University of California San Francisco, San Francisco, CA,USA
| | - Janeth Ochoa Birrueta
- Department of Pediatrics, University of California San Francisco, San Francisco, CA,USA
| | - William C. Chen
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | | | - Shawn L. Hervey-Jumper
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ophir D. Klein
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Christine M. Toedebusch
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Craig M. Horbinski
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
- Department of Pathology, Northwestern University, Chicago, IL, USA
| | - Stephen T. Magill
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Aparna Bhaduri
- Department of Biological Chemistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Arie Perry
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Peter J. Dickinson
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Amy B. Heimberger
- Department of Neurological Surgery, Northwestern University, Chicago, IL, USA
| | - Alan Ashworth
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth E. Crouch
- Department of Pediatrics, University of California San Francisco, San Francisco, CA,USA
- The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA, USA
| | - David R. Raleigh
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
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11
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Azab MA, Cole K, Earl E, Cutler C, Mendez J, Karsy M. Medical Management of Meningiomas. Neurosurg Clin N Am 2023; 34:319-333. [PMID: 37210123 DOI: 10.1016/j.nec.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Meningiomas represent the most common type of benign tumor of the extra-axial compartment. Although most meningiomas are benign World Health Organization (WHO) grade 1 lesions, the increasingly prevalent of WHO grade 2 lesion and occasional grade 3 lesions show worsened recurrence rates and morbidity. Multiple medical treatments have been evaluated but show limited efficacy. We review the status of medical management in meningiomas, highlighting successes and failures of various treatment options. We also explore newer studies evaluating the use of immunotherapy in management.
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Affiliation(s)
- Mohammed A Azab
- Biomolecular Sciences Graduate Program, Boise State University, 1910 University Drive, Boise, ID 83725, USA
| | - Kyril Cole
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA
| | - Emma Earl
- School of Medicine, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA
| | - Chris Cutler
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 N Green Bay Rd., North Chicago, IL 60064, USA
| | - Joe Mendez
- Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Dr., Salt Lake City, UT 84112, USA
| | - Michael Karsy
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA.
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12
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Khan M, Hanna C, Findlay M, Lucke-Wold B, Karsy M, Jensen RL. Modeling Meningiomas: Optimizing Treatment Approach. Neurosurg Clin N Am 2023; 34:479-492. [PMID: 37210136 DOI: 10.1016/j.nec.2023.02.014] [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] [Indexed: 05/22/2023]
Abstract
Preclinical meningioma models offer a setting to test molecular mechanisms of tumor development and targeted treatment options but historically have been challenging to generate. Few spontaneous tumor models in rodents have been established, but cell culture and in vivo rodent models have emerged along with artificial intelligence, radiomics, and neural networks to differentiate the clinical heterogeneity of meningiomas. We reviewed 127 studies using PRISMA guideline methodology, including laboratory and animal studies, that addressed preclinical modeling. Our evaluation identified that meningioma preclinical models provide valuable molecular insight into disease progression and effective chemotherapeutic and radiation approaches for specific tumor types.
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Affiliation(s)
- Majid Khan
- Reno School of Medicine, University of Nevada, Reno, NV, USA
| | - Chadwin Hanna
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Matthew Findlay
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Michael Karsy
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA.
| | - Randy L Jensen
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA
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13
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Bolte AC, Shapiro DA, Dutta AB, Ma WF, Bruch KR, Kovacs MA, Royo Marco A, Ennerfelt HE, Lukens JR. The meningeal transcriptional response to traumatic brain injury and aging. eLife 2023; 12:e81154. [PMID: 36594818 PMCID: PMC9810333 DOI: 10.7554/elife.81154] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
Emerging evidence suggests that the meningeal compartment plays instrumental roles in various neurological disorders, however, we still lack fundamental knowledge about meningeal biology. Here, we utilized high-throughput RNA sequencing (RNA-seq) techniques to investigate the transcriptional response of the meninges to traumatic brain injury (TBI) and aging in the sub-acute and chronic time frames. Using single-cell RNA sequencing (scRNA-seq), we first explored how mild TBI affects the cellular and transcriptional landscape in the meninges in young mice at one-week post-injury. Then, using bulk RNA-seq, we assessed the differential long-term outcomes between young and aged mice following TBI. In our scRNA-seq studies, we highlight injury-related changes in differential gene expression seen in major meningeal cell populations including macrophages, fibroblasts, and adaptive immune cells. We found that TBI leads to an upregulation of type I interferon (IFN) signature genes in macrophages and a controlled upregulation of inflammatory-related genes in the fibroblast and adaptive immune cell populations. For reasons that remain poorly understood, even mild injuries in the elderly can lead to cognitive decline and devastating neuropathology. To better understand the differential outcomes between the young and the elderly following brain injury, we performed bulk RNA-seq on young and aged meninges 1.5 months after TBI. Notably, we found that aging alone induced upregulation of meningeal genes involved in antibody production by B cells and type I IFN signaling. Following injury, the meningeal transcriptome had largely returned to its pre-injury signature in young mice. In stark contrast, aged TBI mice still exhibited upregulation of immune-related genes and downregulation of genes involved in extracellular matrix remodeling. Overall, these findings illustrate the dynamic transcriptional response of the meninges to mild head trauma in youth and aging.
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Affiliation(s)
- Ashley C Bolte
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of MedicineCharlottesvilleUnited States
- Medical Scientist Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
- Immunology Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
| | - Daniel A Shapiro
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
| | - Arun B Dutta
- Medical Scientist Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
- Department of Biochemistry and Molecular Genetics, University of Virginia School of MedicineCharlottesvilleUnited States
| | - Wei Feng Ma
- Medical Scientist Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
- Center for Public Health Genomics, University of Virginia School of MedicineCharlottesvilleUnited States
| | - Katherine R Bruch
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
| | - Michael A Kovacs
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of MedicineCharlottesvilleUnited States
- Medical Scientist Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
- Immunology Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
| | - Ana Royo Marco
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of MedicineCharlottesvilleUnited States
| | - Hannah E Ennerfelt
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
| | - John R Lukens
- Department of Neuroscience, Center for Brain Immunology and Glia (BIG), University of Virginia School of MedicineCharlottesvilleUnited States
- Medical Scientist Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
- Immunology Training Program, University of Virginia School of MedicineCharlottesvilleUnited States
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14
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Laurenge A, Huillard E, Bielle F, Idbaih A. Cell of Origin of Brain and Spinal Cord Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1394:85-101. [PMID: 36587383 DOI: 10.1007/978-3-031-14732-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A better understanding of cellular and molecular biology of primary central nervous system (CNS) tumors is a critical step toward the design of innovative treatments. In addition to improving knowledge, identification of the cell of origin in tumors allows for sharp and efficient targeting of specific tumor cells promoting and driving oncogenic processes. The World Health Organization identifies approximately 150 primary brain tumor subtypes with various ontogeny and clinical outcomes. Identification of the cell of origin of each tumor type with its lineage and differentiation level is challenging. In the current chapter, we report the suspected cell of origin of various CNS primary tumors including gliomas, glioneuronal tumors, medulloblastoma, meningioma, atypical teratoid rhabdoid tumor, germinomas, and lymphoma. Most of them have been pinpointed through transgenic mouse models and analysis of molecular signatures of tumors. Identification of the cell or cells of origin in primary brain tumors will undoubtedly open new therapeutic avenues, including the reactivation of differentiation programs for therapeutic perspectives.
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Affiliation(s)
- Alice Laurenge
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau-Paris Brain Institute, ICM, Service de Neurologie 2-Mazarin, 75013, Paris, France
| | - Emmanuelle Huillard
- INSERM, CNRS, APHP, Institut du Cerveau-Paris Brain Institute (ICM), Sorbonne Université, Paris, France
| | - Franck Bielle
- AP-HP, SIRIC CURAMUS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de La Moelle Épinière, ICM, Service de Neuropathologie Escourolle, 75013, Paris, France
| | - Ahmed Idbaih
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau-Paris Brain Institute, ICM, Service de Neurologie 2-Mazarin, 75013, Paris, France.
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15
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Danish H, Brastianos P. Novel Medical Therapies in Meningiomas. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1416:213-223. [PMID: 37432630 DOI: 10.1007/978-3-031-29750-2_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Meningiomas are the most common primary brain tumor in adults and have been historically managed with surgery and radiation therapy. However, in patients with inoperable, recurrent or high-grade tumors, medical therapy is often needed. Traditional chemotherapy and hormone therapy have been largely ineffective. However, with improved understanding of the molecular drivers in meningioma, there has been increasing interest in targeted molecular and immune therapies. In this chapter, we will discuss recent advances in meningioma genetics and biology and review current clinical trials with targeted molecular treatment and other novel therapies.
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Affiliation(s)
- Husain Danish
- Massachusetts General Hospital, Divisions of Neuro-Oncology and Hematology/Oncology, Departments of Neurology and Medicine, Harvard Medical School, Boston, MA, USA.
| | - Priscilla Brastianos
- Massachusetts General Hospital, Divisions of Neuro-Oncology and Hematology/Oncology, Departments of Neurology and Medicine, Harvard Medical School, Boston, MA, USA.
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16
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Maier AD. Malignant meningioma. APMIS 2022; 130 Suppl 145:1-58. [DOI: 10.1111/apm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
- Department of Pathology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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17
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Jiam NT, Gillard DM, Morshed RA, Bhutada AS, Crawford ED, Braunstein SW, Henderson Sabes J, Theodosopoulos PV, Cheung SW. Treated large posterior fossa vestibular schwannoma and meningioma: Hearing outcome and willingness-to-accept brain implant for unilateral deafness. Laryngoscope Investig Otolaryngol 2022; 7:2057-2063. [PMID: 36544942 PMCID: PMC9764787 DOI: 10.1002/lio2.957] [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: 05/23/2022] [Revised: 10/05/2022] [Accepted: 10/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background/Objective To compare functional hearing and tinnitus outcomes in treated large (~ 3 cm) vestibular schwannoma (VS) and posterior fossa meningioma cohorts, and construct willingness-to-accept profiles for an experimental brain implant to treat unilateral hearing loss. Methods A two-way MANOVA model with two independent variables (tumor type; time from treatment) and three dependent variables (hearing effort of tumor ear; abbreviated Speech, Spatial, and Qualities of Hearing scale (SSQ12); Tinnitus Functional Index (TFI)) was used to analyze data from VS (N = 32) and meningioma (N = 50) patients who were treated at a tertiary care center between 2010 and 2020. A query to probe acceptance of experimental treatment for hearing loss relative to expected benefit was used to construct willingness-to-accept profiles. Results Tumor type was statistically significant on the combined dependent variables analysis (F[3, 76] = 19.172, p < .0005, Wilks' Λ = 0.569). Meningioma showed better outcome for hearing effort (F[1, 76] = 14.632, p < .0005) and SSQ12 (F[1, 76] = 16.164, p < .0005), but not for TFI (F[1, 76] = 1.247, p = .268) on univariate two-way ANOVA analyses. Superior hearing effort and SSQ12 indices in the short-term (< 2 years) persisted in the long-term (> 2 years) (p ≤ .017). At the 60% speech understanding level, 77% of respondents would accept an experimental brain implant. Conclusion Hearing outcome is better for posterior fossa meningioma compared to VS. Most patients with hearing loss in the tumor ear would consider a brain implant if the benefit level would be comparable to a cochlear implant. Level of Evidence 2.
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Affiliation(s)
- Nicole T. Jiam
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Danielle M. Gillard
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Ramin A. Morshed
- Department of NeurosurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Ethan D. Crawford
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Steve W. Braunstein
- Department of Radiation OncologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Jennifer Henderson Sabes
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Steven W. Cheung
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of CaliforniaSan FranciscoCaliforniaUSA,Surgical Services, San Francisco Veterans Affairs Health Care SystemSan FranciscoCaliforniaUSA
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18
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Safronova EI, Galstyan SA, Kushel YV. Trans-eyebrow supraorbital endoscope-assisted keyhole approach to suprasellar meningioma in pediatric patient: case report and literature review. Chin Neurosurg J 2022; 8:28. [PMID: 36104809 PMCID: PMC9472336 DOI: 10.1186/s41016-022-00299-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Meningiomas are rather uncommon tumors in the pediatric population, differing significantly from those found in adults by their atypical location, higher rate of more malignant types, consequently higher risk of recurrence and a less favorable outcome. Even in children, suprasellar meningiomas without dural matrix are rare findings mimicking more common suprasellar lesions. Case presentation Here we describe a case of a 12-year-old girl who presented with a rapidly progressing chiasmal syndrome and was diagnosed by MRI with an unusual suprasellar tumor that could not fit the diagnoses expected in a case of a parasellar mass in a child, similar to a craniopharyngioma or optic pathway glioma. After multiple clinical investigations, the tumor etiology was still unclear, so the preferred option of treatment was surgical resection. An endoscope-assisted gross total resection through a supraorbital keyhole approach was performed uneventfully, with total vision recovery in a short time. Benign meningiomas located in the skull base without dural attachment appear to be rare, even in pediatric patients. Conclusion Differential diagnoses of suprasellar and para sellar tumor lesions in pediatric patients can be confusing. There are peculiar features of pediatric tumor diseases that should be considered while working out the management strategy. The main principle of meningioma treatment is the highest possible extent of resection minimally affecting the quality of life.
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19
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Slavik H, Balik V, Kokas FZ, Slavkovsky R, Vrbkova J, Rehulkova A, Lausova T, Ehrmann J, Gurska S, Uberall I, Hajduch M, Srovnal J. Transcriptomic Profiling Revealed Lnc-GOLGA6A-1 as a Novel Prognostic Biomarker of Meningioma Recurrence. Neurosurgery 2022; 91:360-369. [PMID: 35551164 PMCID: PMC9287111 DOI: 10.1227/neu.0000000000002026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/10/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Meningioma is the most common primary central nervous system neoplasm, accounting for about a third of all brain tumors. Because their growth rates and prognosis cannot be accurately estimated, biomarkers that enable prediction of their biological behavior would be clinically beneficial. OBJECTIVE To identify coding and noncoding RNAs crucial in meningioma prognostication and pathogenesis. METHODS Total RNA was purified from formalin-fixed and paraffin-embedded tumor samples of 64 patients with meningioma with distinct clinical characteristics (16 recurrent, 30 nonrecurrent with follow-up of >5 years, and 18 with follow-up of <5 years without recurrence). Transcriptomic sequencing was performed using the HiSeq 2500 platform (Illumina), and biological and functional differences between meningiomas of different types were evaluated by analyzing differentially expression of messenger RNA (mRNA) and long noncoding RNA (IncRNA). The prognostic value of 11 differentially expressed RNAs was then validated in an independent cohort of 90 patients using reverse transcription quantitative (real-time) polymerase chain reaction. RESULTS In total, 69 mRNAs and 108 lncRNAs exhibited significant differential expression between recurrent and nonrecurrent meningiomas. Differential expression was also observed with respect to sex (12 mRNAs and 59 lncRNAs), World Health Organization grade (58 mRNAs and 98 lncRNAs), and tumor histogenesis (79 mRNAs and 76 lncRNAs). Lnc-GOLGA6A-1, ISLR2, and AMH showed high prognostic power for predicting meningioma recurrence, while lnc-GOLGA6A-1 was the most significant factor for recurrence risk estimation (1/hazard ratio = 1.31; P = .002). CONCLUSION Transcriptomic sequencing revealed specific gene expression signatures of various clinical subtypes of meningioma. Expression of the lnc-GOLGA61-1 transcript was found to be the most reliable predictor of meningioma recurrence.
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Affiliation(s)
- Hanus Slavik
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
- Department of Neurology, University Hospital Olomouc, Olomouc, Czech Republic;
| | - Vladimir Balik
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
- Department of Neurosurgery, Svet Zdravia Hospital Michalovce, Michalovce, Slovak Republic;
- Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Filip Zavadil Kokas
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic;
| | - Rastislav Slavkovsky
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Jana Vrbkova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Alona Rehulkova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Tereza Lausova
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Jiri Ehrmann
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Sona Gurska
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Ivo Uberall
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Marian Hajduch
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
| | - Josef Srovnal
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic;
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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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21
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Antonica F, Aiello G, Soldano A, Abballe L, Miele E, Tiberi L. Modeling Brain Tumors: A Perspective Overview of in vivo and Organoid Models. Front Mol Neurosci 2022; 15:818696. [PMID: 35706426 PMCID: PMC9190727 DOI: 10.3389/fnmol.2022.818696] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
Brain tumors are a large and heterogeneous group of neoplasms that affect the central nervous system and include some of the deadliest cancers. Almost all the conventional and new treatments fail to hinder tumoral growth of the most malignant brain tumors. This is due to multiple factors, such as intra-tumor heterogeneity, the microenvironmental properties of the human brain, and the lack of reliable models to test new therapies. Therefore, creating faithful models for each tumor and discovering tailored treatments pose great challenges in the fight against brain cancer. Over the years, different types of models have been generated, and, in this review, we investigated the advantages and disadvantages of the models currently used.
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Affiliation(s)
- Francesco Antonica
- Armenise-Harvard Laboratory of Brain Disorders and Cancer, Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Giuseppe Aiello
- Armenise-Harvard Laboratory of Brain Disorders and Cancer, Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Alessia Soldano
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Luana Abballe
- Department of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children’s Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Evelina Miele
- Department of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children’s Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Luca Tiberi
- Armenise-Harvard Laboratory of Brain Disorders and Cancer, Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
- *Correspondence: Luca Tiberi,
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Roehrkasse AM, Peterson JEG, Fung KM, Pelargos PE, Dunn IF. The Discrepancy Between Standard Histologic WHO Grading of Meningioma and Molecular Profile: A Single Institution Series. Front Oncol 2022; 12:846232. [PMID: 35299730 PMCID: PMC8921552 DOI: 10.3389/fonc.2022.846232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Meningiomas are the most common primary central nervous system (CNS) tumor. They are most often benign, but a subset of these can behave aggressively. Current World Health Organization (WHO) guidelines classify meningiomas into three grades based on the histologic findings and presence or absence of brain invasion. These grades are intended to guide treatment, but meningiomas can behave inconsistently with regard to their assigned histopathological grade, influencing patient expectations and management. Advanced molecular profiling of meningiomas has led to the proposal of alternative molecular grading schemes that have shown superior predictive power. These include methylation patterns, copy number alterations, and mutually exclusive driver mutations affecting oncogenes, including BAP1, CDKN2A/B, and the TERT promoter, which are associated with particularly aggressive tumor biology. Despite the evident clinical value, advanced molecular profiling methods are not widely incorporated in routine clinical practice for meningiomas. Objective To assess the degree of concordance between the molecular profile of meningiomas and the histopathologic WHO classification, the current method of predicting meningioma behavior. Methods In a two-year single-institution experience, we used commercially available resources to determine molecular profiles of all resected meningiomas. Copy number aberrations and oncogenic driver mutations were identified and compared with the histopathologic grade. Results One hundred fifty-one total meningioma cases were included for analysis (85.4% WHO grade 1, 13.3% WHO grade 2, and 1.3% grade 3). Chromosomal analysis of 124 of these samples showed that 29% of WHO grade 1 tumor featured copy number profiles consistent with higher grade meningioma, and 25% of WHO grade 2 meningiomas had copy number profiles consistent with less aggressive tumors. Furthermore, 8% harbored mutations in TERT, CDKN2A/B, or BAP1 of which 6% occurred in grade 1 meningiomas. Conclusions Routine advanced molecular profiling of all resected meningiomas using commercially available resources allowed for identification of a significant number of meningiomas whose molecular profiles were inconsistent with WHO grade. Our work shows the clinical value of integrating routine molecular profiling with histopathologic grading to guide clinical decision making.
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Affiliation(s)
- Amanda M Roehrkasse
- Dunn Laboratory, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jo Elle G Peterson
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Kar-Ming Fung
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Panayiotis E Pelargos
- Dunn Laboratory, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ian F Dunn
- Dunn Laboratory, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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24
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Uhlmann EJ, Rabinovsky R, Varma H, El Fatimy R, Kasper EM, Moore JM, Vega RA, Thomas AJ, Alterman RL, Stippler M, Anderson MP, Uhlmann EN, Kipper FC, Krichevsky AM. Tumor-Derived Cell Culture Model for the Investigation of Meningioma Biology. J Neuropathol Exp Neurol 2021; 80:1117-1124. [PMID: 34850056 PMCID: PMC8716066 DOI: 10.1093/jnen/nlab111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Meningioma is the most common primary central nervous system tumor. Although mostly nonmalignant, meningioma can cause serious complications by mass effect and vasogenic edema. While surgery and radiation improve outcomes, not all cases can be treated due to eloquent location. Presently no medical treatment is available to slow meningioma growth owing to incomplete understanding of the underlying pathology, which in turn is due to the lack of high-fidelity tissue culture and animal models. We propose a simple and rapid method for the establishment of meningioma tumor-derived primary cultures. These cells can be maintained in culture for a limited time in serum-free media as spheres and form adherent cultures in the presence of 4% fetal calf serum. Many of the tissue samples show expression of the lineage marker PDG2S, which is typically retained in matched cultured cells, suggesting the presence of cells of arachnoid origin. Furthermore, nonarachnoid cells including vascular endothelial cells are also present in the cultures in addition to arachnoid cells, potentially providing a more accurate tumor cell microenvironment, and thus making the model more relevant for meningioma research and high-throughput drug screening.
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Affiliation(s)
- Erik J Uhlmann
- From the Department of Neurology, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rosalia Rabinovsky
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hemant Varma
- Department of Pathology, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rachid El Fatimy
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ekkehard M Kasper
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Justin M Moore
- Department of Neurosurgery, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rafael A Vega
- Department of Neurosurgery, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ajith J Thomas
- Department of Neurosurgery, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald L Alterman
- Department of Neurosurgery, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Martina Stippler
- Department of Neurosurgery, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew P Anderson
- Department of Pathology, Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Erik N Uhlmann
- Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada.,Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Franciela C Kipper
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Anna M Krichevsky
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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25
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Hosainey SAM, Bouget D, Reinertsen I, Sagberg LM, Torp SH, Jakola AS, Solheim O. Are there predilection sites for intracranial meningioma? A population-based atlas. Neurosurg Rev 2021; 45:1543-1552. [PMID: 34674099 PMCID: PMC8976805 DOI: 10.1007/s10143-021-01652-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/06/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022]
Abstract
Meningioma is the most common benign intracranial tumor and is believed to arise from arachnoid cap cells of arachnoid granulations. We sought to develop a population-based atlas from pre-treatment MRIs to explore the distribution of intracranial meningiomas and to explore risk factors for development of intracranial meningiomas in different locations. All adults (≥ 18 years old) diagnosed with intracranial meningiomas and referred to the department of neurosurgery from a defined catchment region between 2006 and 2015 were eligible for inclusion. Pre-treatment T1 contrast-enhanced MRI-weighted brain scans were used for semi-automated tumor segmentation to develop the meningioma atlas. Patient variables used in the statistical analyses included age, gender, tumor locations, WHO grade and tumor volume. A total of 602 patients with intracranial meningiomas were identified for the development of the brain tumor atlas from a wide and defined catchment region. The spatial distribution of meningioma within the brain is not uniform, and there were more tumors in the frontal region, especially parasagittally, along the anterior part of the falx, and on the skull base of the frontal and middle cranial fossa. More than 2/3 meningioma patients were females (p < 0.001) who also were more likely to have multiple meningiomas (p < 0.01), while men more often have supratentorial meningiomas (p < 0.01). Tumor location was not associated with age or WHO grade. The distribution of meningioma exhibits an anterior to posterior gradient in the brain. Distribution of meningiomas in the general population is not dependent on histopathological WHO grade, but may be gender-related.
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Affiliation(s)
| | - David Bouget
- Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingerid Reinertsen
- Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lisa Millgård Sagberg
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sverre Helge Torp
- Department of Laboratory Medicine, Children and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pathology and Medical Genetics, St. Olavs Hospital, Trondheim, Norway
| | - Asgeir Store Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Ole Solheim
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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26
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Receptor Tyrosine Kinases as Candidate Prognostic Biomarkers and Therapeutic Targets in Meningioma. Int J Mol Sci 2021; 22:ijms222111352. [PMID: 34768783 PMCID: PMC8583503 DOI: 10.3390/ijms222111352] [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: 08/25/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022] Open
Abstract
Meningioma (MGM) is the most common type of intracranial tumor in adults. The validation of novel prognostic biomarkers to better inform tumor stratification and clinical prognosis is urgently needed. Many molecular and cellular alterations have been described in MGM tumors over the past few years, providing a rational basis for the identification of biomarkers and therapeutic targets. The role of receptor tyrosine kinases (RTKs) as oncogenes, including those of the ErbB family of receptors, has been well established in several cancer types. Here, we review histological, molecular, and clinical evidence suggesting that RTKs, including the epidermal growth factor receptor (EGFR, ErbB1), as well as other members of the ErbB family, may be useful as biomarkers and therapeutic targets in MGM.
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27
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Peyre M, Miyagishima D, Bielle F, Chapon F, Sierant M, Venot Q, Lerond J, Marijon P, Abi-Jaoude S, Le Van T, Labreche K, Houlston R, Faisant M, Clémenceau S, Boch AL, Nouet A, Carpentier A, Boetto J, Louvi A, Kalamarides M. Somatic PIK3CA Mutations in Sporadic Cerebral Cavernous Malformations. N Engl J Med 2021; 385:996-1004. [PMID: 34496175 PMCID: PMC8606022 DOI: 10.1056/nejmoa2100440] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Cerebral cavernous malformations (CCMs) are common sporadic and inherited vascular malformations of the central nervous system. Although familial CCMs are linked to loss-of-function mutations in KRIT1 (CCM1), CCM2, or PDCD10 (CCM3), the genetic cause of sporadic CCMs, representing 80% of cases, remains incompletely understood. METHODS We developed two mouse models harboring mutations identified in human meningiomas with the use of the prostaglandin D2 synthase (PGDS) promoter. We performed targeted DNA sequencing of surgically resected CCMs from patients and confirmed our findings by droplet digital polymerase-chain-reaction analysis. RESULTS We found that in mice expressing one of two common genetic drivers of meningioma - Pik3ca H1047R or AKT1 E17K - in PGDS-positive cells, a spectrum of typical CCMs develops (in 22% and 11% of the mice, respectively) instead of meningiomas, which prompted us to analyze tissue samples from sporadic CCMs from 88 patients. We detected somatic activating PIK3CA and AKT1 mutations in 39% and 1%, respectively, of lesion tissue from the patients. Only 10% of lesions harbored mutations in the CCM genes. We analyzed lesions induced by the activating mutations Pik3ca H1074R and AKT1 E17K in mice and identified the PGDS-expressing pericyte as the probable cell of origin. CONCLUSIONS In tissue samples from sporadic CCMs, mutations in PIK3CA were represented to a greater extent than mutations in any other gene. The contribution of somatic mutations in the genes that cause familial CCMs was comparatively small. (Funded by the Fondation ARC pour la Recherche contre le Cancer and others.).
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Affiliation(s)
- Matthieu Peyre
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Danielle Miyagishima
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Franck Bielle
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Françoise Chapon
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Michael Sierant
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Quitterie Venot
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Julie Lerond
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Pauline Marijon
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Samiya Abi-Jaoude
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Tuan Le Van
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Karim Labreche
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Richard Houlston
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Maxime Faisant
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Stéphane Clémenceau
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Anne-Laure Boch
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Aurelien Nouet
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Alexandre Carpentier
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Julien Boetto
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Angeliki Louvi
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
| | - Michel Kalamarides
- From the Departments of Neurosurgery (M.P., S.C., A.-L.B., A.N., A.C., M.K.) and Neuropathology (F.B.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, INSERM Unité 1127, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7225, Paris Brain Institute (M.P., F.B., J.L., P.M., S.A.-J., T.L.V., K.L., J.B., M.K.), and INSERM Unité 1151-Institut Necker Enfants Malades, Hôpital Necker Enfants Malades, AP-HP (Q.V.), Paris, and the Department of Pathology, Centre Hospitalier Régional Universitaire (CHRU) Caen-INSERM Unité 1075 COMETE, Caen University (F.C.), and the Department of Pathology CHRU Caen-INSERM Unité Mixte de Recherche en Santé Unité 1237, Cyceron (M.F.), Caen - all in France; the Departments of Genetics (D.M., M.S.) and Neurosurgery and Neuroscience (A.L.), Yale School of Medicine, New Haven, CT; and the Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom (K.L., R.H.)
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Boetto J, Peyre M, Kalamarides M. Mouse Models in Meningioma Research: A Systematic Review. Cancers (Basel) 2021; 13:cancers13153712. [PMID: 34359639 PMCID: PMC8345085 DOI: 10.3390/cancers13153712] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/10/2021] [Accepted: 07/21/2021] [Indexed: 12/21/2022] Open
Abstract
Meningiomas are the most frequent primitive central nervous system tumors found in adults. Mouse models of cancer have been instrumental in understanding disease mechanisms and establishing preclinical drug testing. Various mouse models of meningioma have been developed over time, evolving in light of new discoveries in our comprehension of meningioma biology and with improvements in genetic engineering techniques. We reviewed all mouse models of meningioma described in the literature, including xenograft models (orthotopic or heterotopic) with human cell lines or patient derived tumors, and genetically engineered mouse models (GEMMs). Xenograft models provided useful tools for preclinical testing of a huge range of innovative drugs and therapeutic options, which are summarized in this review. GEMMs offer the possibility of mimicking human meningiomas at the histological, anatomical, and genetic level and have been invaluable in enabling tumorigenesis mechanisms, including initiation and progression, to be dissected. Currently, researchers have a range of different mouse models that can be used depending on the scientific question to be answered.
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Affiliation(s)
- Julien Boetto
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier Universitary Hospital Center, 80 Avenue Augustin Fliche, 34090 Montpellier, France;
- Institut du Cerveau et de la Moelle Épinière, INSERM U1127 CNRS UMR 7225, F-75013 Paris, France;
| | - Matthieu Peyre
- Institut du Cerveau et de la Moelle Épinière, INSERM U1127 CNRS UMR 7225, F-75013 Paris, France;
- Department of Neurosurgery, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, F-75013 Paris, France
| | - Michel Kalamarides
- Institut du Cerveau et de la Moelle Épinière, INSERM U1127 CNRS UMR 7225, F-75013 Paris, France;
- Department of Neurosurgery, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, F-75013 Paris, France
- Correspondence:
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TMEM16C is involved in thermoregulation and protects rodent pups from febrile seizures. Proc Natl Acad Sci U S A 2021; 118:2023342118. [PMID: 33972431 PMCID: PMC8157992 DOI: 10.1073/pnas.2023342118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As the most common convulsive disorder in infancy and childhood, affecting 2 to 5% of American children in their first 5 y of life, febrile seizures (FSs) are associated with genetic risk factors, including the Tmem16c (Ano3) gene. Whereas central neuronal hyperexcitability has been implicated in FSs, whether FSs may result from compromised body temperature regulation is unknown. To approach this question, we developed rodent models of FSs associated with deficient thermoregulation, including conditional knockout mice with TMEM16C eliminated from a hypothalamic neuronal population important for maintaining body temperature but not from most of the cortical and hippocampal neurons and sensory neurons. Our findings raise the possibility that impaired homeostatic thermoregulation could contribute to the risk of FSs. Febrile seizures (FSs) are the most common convulsion in infancy and childhood. Considering the limitations of current treatments, it is important to examine the mechanistic cause of FSs. Prompted by a genome-wide association study identifying TMEM16C (also known as ANO3) as a risk factor of FSs, we showed previously that loss of TMEM16C function causes hippocampal neuronal hyperexcitability [Feenstra et al., Nat. Genet. 46, 1274–1282 (2014)]. Our previous study further revealed a reduction in the number of warm-sensitive neurons that increase their action potential firing rate with rising temperature of the brain region harboring these hypothalamic neurons. Whereas central neuronal hyperexcitability has been implicated in FSs, it is unclear whether the maximal temperature reached during fever or the rate of body temperature rise affects FSs. Here we report that mutant rodent pups with TMEM16C eliminated from all or a subset of their central neurons serve as FS models with deficient thermoregulation. Tmem16c knockout (KO) rat pups at postnatal day 10 (P10) are more susceptible to hyperthermia-induced seizures. Moreover, they display a more rapid rise of body temperature upon heat exposure. In addition, conditional knockout (cKO) mouse pups (P11) with TMEM16C deletion from the brain display greater susceptibility of hyperthermia-induced seizures as well as deficiency in thermoregulation. We also found similar phenotypes in P11 cKO mouse pups with TMEM16C deletion from Ptgds-expressing cells, including temperature-sensitive neurons in the preoptic area (POA) of the anterior hypothalamus, the brain region that controls body temperature. These findings suggest that homeostatic thermoregulation plays an important role in FSs.
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Abstract
Comprehensive genomic studies of meningioma have offered important insights about the molecular mechanisms underlying this common brain tumor. The use of next-generation sequencing techniques has identified driver mutations in approximately 80% of benign sporadic lesions, as well as epigenetic, regulatory, and copy number events that are associated with formation and disease progression. The events described to date fall into five mutually exclusive molecular subgroups that correlate with tumor location and embryological origin. Importantly, these subgroups also carry implications for clinical management, as they are predictive of histologic subtype and the likelihood of progression. Further work is necessary to understand the molecular mechanisms by which identified mutations drive tumorigenesis as well as the genomic pathways that transform benign lesions into malignancies. Progress made during the past decade has opened the door to potential molecular therapies as well as integration of meningioma genotyping data into clinical management decisions. Several pharmacologic trials are currently underway that leverage recent genomic findings to target established oncogenic pathways in refractory tumors. With the combined efforts of physicians and basic science investigators, the clinical management of meningioma will continue to make important strides in the coming years.
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Okano A, Miyawaki S, Hongo H, Dofuku S, Teranishi Y, Mitsui J, Tanaka M, Shin M, Nakatomi H, Saito N. Associations of pathological diagnosis and genetic abnormalities in meningiomas with the embryological origins of the meninges. Sci Rep 2021; 11:6987. [PMID: 33772057 PMCID: PMC7998008 DOI: 10.1038/s41598-021-86298-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 03/15/2021] [Indexed: 11/26/2022] Open
Abstract
Certain driver mutations and pathological diagnoses are associated with the anatomical site of meningioma, based on which the meninges have different embryological origins. We hypothesized that mutations and pathological diagnoses of meningiomas are associated with different embryological origins. We comprehensively evaluated associations among tumor location, pathological diagnosis (histological type), and genetic alterations including AKT1, KLF4, SMO, POLR2A, and NF2 mutations and 22q deletion in 269 meningioma cases. Based on the embryological origin of meninges, the tumor locations were as follows: neural crest, paraxial mesodermal, and dorsal mesodermal origins. Tumors originating from the dura of certain embryologic origin displayed a significantly different pathological diagnoses and genetic abnormality ratio. For instance, driver genetic mutations with AKT1, KLF4, SMO, and POLR2A, were significantly associated with the paraxial mesodermal origin (p = 1.7 × 10−10). However, meningiomas with NF2-associated mutations were significantly associated with neural crest origin (p = 3.9 × 10–12). On analysis of recurrence, no difference was observed in embryological origin. However, POLR2A mutation was a risk factor for the tumor recurrence (p = 1.7 × 10−2, Hazard Ratio 4.08, 95% Confidence Interval 1.28–13.0). Assessment of the embryological origin of the meninges may provide novel insights into the pathomechanism of meningiomas.
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Affiliation(s)
- Atsushi Okano
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Hiroki Hongo
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shogo Dofuku
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yu Teranishi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Jun Mitsui
- Department of Molecular Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Michihiro Tanaka
- Departments of Neuroendovascular Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan
| | - Masahiro Shin
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hirofumi Nakatomi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Ogasawara C, Philbrick BD, Adamson DC. Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions. Biomedicines 2021; 9:biomedicines9030319. [PMID: 33801089 PMCID: PMC8004084 DOI: 10.3390/biomedicines9030319] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. They are mostly benign tumors that can be observed or preferentially treated with gross total resection that provides good outcomes. Meningiomas with complicated histology or in compromising locations has proved to be a challenge in treating and predicting prognostic outcomes. Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence. With the study and detection of genomic aberrancies, specific biologic targets are now being trialed for possible management of meningiomas that are not responsive to standard surgery and radiotherapy treatment. This review summarizes current epidemiology, etiology, molecular characteristics, diagnosis, treatments, and current treatment trials.
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Affiliation(s)
- Christian Ogasawara
- Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI 96813, USA;
| | - Brandon D. Philbrick
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - D. Cory Adamson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Department of Neurosurgery, Atlanta VA Medical Center, Atlanta, GA 30322, USA
- Correspondence: ; Tel.: +1-(919)-698-3152
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Abstract
PURPOSE OF REVIEW To discuss recent advances in the meningioma biology and their clinical implications. RECENT FINDINGS Meningioma is the most common primary intracranial tumor. Mostly benign, 20% of cases display an aggressive behavior despite best standard of care. The genetic landscape of meningiomas is divided according to NF2 mutational status. Although about 60% of meningiomas display NF2 mutations, the other share is more heterogenous. Mutations in TRAF7, SMO, v-akt murine thymoma viral oncogene homolog 1 (AKT1), PI3KCA and KLF4 are seen mostly in WHO grade 1 meningiomas. In higher grade meningiomas, mutations of the TERT promoter and deletions of CDKN2A/B emerge and have prognostic value. Moreover, mutations in DMD, BAP1 and PBRM1 have recently been discovered and are being further explored. DNA methylation subgroups offer valuable insight into meningioma prognosis and its implementation in clinical setting is under evaluation. Moreover, the study of distinct meningioma populations such as radiation-induced meningioma and progestin-associated meningioma may provide further insight into meningioma oncogenesis and potential therapeutic targets. SUMMARY The mutational landscape of meningioma has expanded following the use of the new genetic sequencing approaches. Novel mutations have been characterized and reveal their prognostic and therapeutic applications. This improved understanding of meningioma biology has promising implications for novel treatment strategies.
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Mooney MA, Abolfotoh M, Bi WL, Tavanaiepour D, Almefty RO, Bassiouni H, Pravdenkova S, Dunn IF, Al-Mefty O. Is Falcine Meningioma a Diffuse Disease of the Falx? Case Series and Analysis of a "Grade Zero" Resection. Neurosurgery 2021; 87:900-909. [PMID: 32294205 DOI: 10.1093/neuros/nyaa038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/28/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Falcine meningiomas have unique characteristics including their high rates of recurrence, association with high grade pathology, increased male prevalence, and potential for diffuse involvement of the falx. OBJECTIVE To address these issues in a substantial series of falcine meningiomas and report on the impact of extent of resection for this distinct meningioma entity. METHODS Retrospective analysis of characteristics and outcomes of 59 falcine meningioma patients who underwent surgery with the senior author. A "Grade Zero" category was used when an additional resection margin of 2 to 3 cm from the tumor insertion was achieved. RESULTS For de novo falcine meningiomas, gross total resection (GTR) was associated with significantly decreased recurrence incidence compared with subtotal resection (P ≤ .0001). For recurrent falcine meningiomas, median progression-free survival (PFS) was significantly improved for GTR cases (37 mo vs 12 mo; P = .017, hazard ratio (HR) .243 (.077-.774)). "Grade Zero" resection demonstrated excellent durability for both de novo and recurrent cases, and PFS was significantly improved with "Grade Zero" resection for recurrent cases (P = .003, HR 1.544 (1.156-2.062)). The PFS benefit of "Grade Zero" resection did not achieve statistical significance over Simpson grade 1 during the limited follow-up period (mean 2.8 yr) for these groups. CONCLUSION The recurrence of falcine meningiomas is related to the diffuse presence of tumor between the leaflets of the falx. Increased extent of resection including, when possible, a clear margin of falx surrounding the tumor base was associated with the best long-term outcomes in our series, particularly for recurrent tumors.
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Affiliation(s)
- Michael A Mooney
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mohammad Abolfotoh
- Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky.,Department of Neurosurgery, Ain Shams University, Cairo, Egypt
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daryoush Tavanaiepour
- Department of Neurosurgery, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida
| | - Rami O Almefty
- Department of Neurosurgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Hischam Bassiouni
- Department of Neurosurgery, Klinikum Amberg, Amberg, Germany.,Department of Neurosurgery, Klinikum Weiden, Weiden, Germany
| | - Svetlana Pravdenkova
- Department of Neurosurgery, Arkansas Neuroscience Institute, Little Rock, Arkansas
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ossama Al-Mefty
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Fountain DM, Smith MJ, O'Leary C, Pathmanaban ON, Roncaroli F, Bobola N, King AT, Evans DG. The spatial phenotype of genotypically distinct meningiomas demonstrate potential implications of the embryology of the meninges. Oncogene 2021; 40:875-884. [PMID: 33262459 PMCID: PMC8440207 DOI: 10.1038/s41388-020-01568-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 12/29/2022]
Abstract
Meningiomas are the most common primary brain tumor and their incidence and prevalence is increasing. This review summarizes current evidence regarding the embryogenesis of the human meninges in the context of meningioma pathogenesis and anatomical distribution. Though not mutually exclusive, chromosomal instability and pathogenic variants affecting the long arm of chromosome 22 (22q) result in meningiomas in neural-crest cell-derived meninges, while variants affecting Hedgehog signaling, PI3K signaling, TRAF7, KLF4, and POLR2A result in meningiomas in the mesodermal-derived meninges of the midline and paramedian anterior, central, and ventral posterior skull base. Current evidence regarding the common pathways for genetic pathogenesis and the anatomical distribution of meningiomas is presented alongside existing understanding of the embryological origins for the meninges prior to proposing next steps for this work.
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Affiliation(s)
- Daniel M Fountain
- Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust and the University of Manchester, Manchester, UK.
| | - Miriam J Smith
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), St Mary's Hospital, School of Biological Sciences, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
| | - Claire O'Leary
- Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust and the University of Manchester, Manchester, UK
| | - Omar N Pathmanaban
- Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust and the University of Manchester, Manchester, UK
| | - Federico Roncaroli
- Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust and the University of Manchester, Manchester, UK
| | - Nicoletta Bobola
- School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Andrew T King
- Geoffrey Jefferson Brain Research Centre, Salford Royal NHS Foundation Trust and the University of Manchester, Manchester, UK
| | - Dafydd Gareth Evans
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), St Mary's Hospital, School of Biological Sciences, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
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Fibulin-2: A Novel Biomarker for Differentiating Grade II from Grade I Meningiomas. Int J Mol Sci 2021; 22:ijms22020560. [PMID: 33429944 PMCID: PMC7827565 DOI: 10.3390/ijms22020560] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/21/2022] Open
Abstract
There is an unmet need for the identification of biomarkers to aid in the diagnosis, clinical management, prognosis and follow-up of meningiomas. There is currently no consensus on the optimum management of WHO grade II meningiomas. In this study, we identified the calcium binding extracellular matrix glycoprotein, Fibulin-2, via mass-spectrometry-based proteomics, assessed its expression in grade I and II meningiomas and explored its potential as a grade II biomarker. A total of 87 grade I and 91 grade II different meningioma cells, tissue and plasma samples were used for the various experimental techniques employed to assess Fibulin-2 expression. The tumours were reviewed and classified according to the 2016 edition of the Classification of the Tumours of the central nervous system (CNS). Mass spectrometry proteomic analysis identified Fibulin-2 as a differentially expressed protein between grade I and II meningioma cell cultures. Fibulin-2 levels were further evaluated in meningioma cells using Western blotting and Real-time Quantitative Polymerase Chain Reaction (RT-qPCR); in meningioma tissues via immunohistochemistry and RT-qPCR; and in plasma via Enzyme-Linked Immunosorbent Assay (ELISA). Proteomic analyses (p < 0.05), Western blotting (p < 0.05) and RT-qPCR (p < 0.01) confirmed significantly higher Fibulin-2 (FBLN2) expression levels in grade II meningiomas compared to grade I. Fibulin-2 blood plasma levels were also significantly higher in grade II meningioma patients compared to grade I patients. This study suggests that elevated Fibulin-2 might be a novel grade II meningioma biomarker, when differentiating them from the grade I tumours. The trend of Fibulin-2 expression observed in plasma may serve as a useful non-invasive biomarker.
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Boetto J, Peyre M, Kalamarides M. Meningiomas from a developmental perspective: exploring the crossroads between meningeal embryology and tumorigenesis. Acta Neurochir (Wien) 2021; 163:57-66. [PMID: 33216210 DOI: 10.1007/s00701-020-04650-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023]
Abstract
Meningiomas are tumors arising from the meninges and represent the most frequent central nervous system tumors in adults. Recent large-scale genetic studies and preclinical meningioma mouse modelling led to a better comprehension of meningioma development and suggested evidences of close relationships between meningeal embryology and tumorigenesis. In this non-systematic review, we summarize the current knowledge on meningeal embryology and developmental biology, and illustrate how meningioma tumorigenesis is deeply related to meningeal embryology, concerning the potential cell of origin, the role of reactivation of embryonic stem cells, the influence of the embryonic tissue of origin, and the parallelism between topography-dependant molecular pathways involved in normal meninges and in meningioma development. Our study emphasizes why future studies on meningeal embryology are mandatory to affine our comprehension of mechanisms underlying meningioma initiation and development.
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Affiliation(s)
- Julien Boetto
- Neurosurgery Department, Gui de Chauliac Hospital, Montpellier University Medical Center, 91 avenue Augustin Fliche, 34090, Montpellier, France.
| | - Matthieu Peyre
- APHP, Groupe Hospitalo-Universitaire Pitié-Salpétrière, Neurosurgery Department, Sorbonne Université, Paris, France
| | - Michel Kalamarides
- APHP, Groupe Hospitalo-Universitaire Pitié-Salpétrière, Neurosurgery Department, Sorbonne Université, Paris, France
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DeSisto J, O'Rourke R, Jones HE, Pawlikowski B, Malek AD, Bonney S, Guimiot F, Jones KL, Siegenthaler JA. Single-Cell Transcriptomic Analyses of the Developing Meninges Reveal Meningeal Fibroblast Diversity and Function. Dev Cell 2021; 54:43-59.e4. [PMID: 32634398 DOI: 10.1016/j.devcel.2020.06.009] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/18/2020] [Accepted: 06/01/2020] [Indexed: 01/18/2023]
Abstract
The meninges are a multilayered structure composed of fibroblasts, blood and lymphatic vessels, and immune cells. Meningeal fibroblasts secrete a variety of factors that control CNS development, yet strikingly little is known about their heterogeneity or development. Using single-cell sequencing, we report distinct transcriptional signatures for fibroblasts in the embryonic dura, arachnoid, and pia. We define new markers for meningeal layers and show conservation in human meninges. We find that embryonic meningeal fibroblasts are transcriptionally distinct between brain regions and identify a regionally localized pial subpopulation marked by the expression of μ-crystallin. Developmental analysis reveals a progressive, ventral-to-dorsal maturation of telencephalic meninges. Our studies have generated an unparalleled view of meningeal fibroblasts, providing molecular profiles of embryonic meningeal fibroblasts by layer and yielding insights into the mechanisms of meninges development and function.
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Affiliation(s)
- John DeSisto
- Department of Pediatrics Section of Hematology, Oncology, Bone Marrow Transplant, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Cell Biology, Stem Cells and Development Graduate Program, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Rebecca O'Rourke
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Hannah E Jones
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Cell Biology, Stem Cells and Development Graduate Program, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Bradley Pawlikowski
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Alexandra D Malek
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Stephanie Bonney
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Cell Biology, Stem Cells and Development Graduate Program, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Fabien Guimiot
- INSERM UMR 1141, Hôpital Robert Debré, 75019 Paris, France
| | - Kenneth L Jones
- Department of Pediatrics Section of Hematology, Oncology, Bone Marrow Transplant, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Julie A Siegenthaler
- Department of Pediatrics Section of Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Cell Biology, Stem Cells and Development Graduate Program, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
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Dunn J, Lenis VP, Hilton DA, Warta R, Herold-Mende C, Hanemann CO, Futschik ME. Integration and Comparison of Transcriptomic and Proteomic Data for Meningioma. Cancers (Basel) 2020; 12:E3270. [PMID: 33167358 PMCID: PMC7694371 DOI: 10.3390/cancers12113270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022] Open
Abstract
Meningioma are the most frequent primary intracranial tumour. Management of aggressive meningioma is complex, and development of effective biomarkers or pharmacological interventions is hampered by an incomplete knowledge of molecular landscape. Here, we present an integrated analysis of two complementary omics studies to investigate alterations in the "transcriptome-proteome" profile of high-grade (III) compared to low-grade (I) meningiomas. We identified 3598 common transcripts/proteins and revealed concordant up- and downregulation in grade III vs. grade I meningiomas. Concordantly upregulated genes included FABP7, a fatty acid binding protein and the monoamine oxidase MAOB, the latter of which we validated at the protein level and established an association with Food and Drug Administration (FDA)-approved drugs. Notably, we derived a plasma signature of 21 discordantly expressed genes showing positive changes in protein but negative in transcript levels of high-grade meningiomas, including the validated genes CST3, LAMP2, PACS1 and HTRA1, suggesting the acquisition of these proteins by tumour from plasma. Aggressive meningiomas were enriched in processes such as oxidative phosphorylation and RNA metabolism, whilst concordantly downregulated genes were related to reduced cellular adhesion. Overall, our study provides the first transcriptome-proteome characterisation of meningioma, identifying several novel and previously described transcripts/proteins with potential grade III biomarker and therapeutic significance.
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Affiliation(s)
- Jemma Dunn
- Faculty of Health: Medicine, Dentistry and Human Sciences, The Institute of Translational and Stratified Medicine, University of Plymouth, The John Bull Building, Plymouth Science Park, Research Way, Plymouth PL6 8BU, UK;
| | - Vasileios P. Lenis
- School of Health & Life Sciences, Centuria Building, Teesside University, Middlesbrough, Tees Valley TS1 3BX, UK;
| | - David A. Hilton
- Cellular and Anatomical Pathology, Plymouth Hospitals NHS Trust, Derriford Road, Plymouth PL6 8BU, UK;
| | - Rolf Warta
- Department of Neurosurgery, Division of Experimental Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; (R.W.); (C.H.-M.)
| | - Christel Herold-Mende
- Department of Neurosurgery, Division of Experimental Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; (R.W.); (C.H.-M.)
| | - C. Oliver Hanemann
- Faculty of Health: Medicine, Dentistry and Human Sciences, The Institute of Translational and Stratified Medicine, University of Plymouth, The John Bull Building, Plymouth Science Park, Research Way, Plymouth PL6 8BU, UK;
| | - Matthias E. Futschik
- Faculty of Medicine, School of Public Health, Imperial College London, Medical School, St Mary’s Hospital, Praed Street, London W2 1NY, UK
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Teranishi Y, Miyawaki S, Hongo H, Dofuku S, Okano A, Takayanagi S, Ota T, Yoshimura J, Qu W, Mitsui J, Nakatomi H, Morishita S, Tsuji S, Saito N. Targeted deep sequencing of DNA from multiple tissue types improves the diagnostic rate and reveals a highly diverse phenotype of mosaic neurofibromatosis type 2. J Med Genet 2020; 58:701-711. [PMID: 33067351 DOI: 10.1136/jmedgenet-2020-106973] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although 60% of patients with de novo neurofibromatosis type 2 (NF2) are presumed to have mosaic NF2, the actual diagnostic rate of this condition remains low at around 20% because of the existing difficulties in detecting NF2 variants with low variant allele frequency (VAF). Here, we examined the correlation between the genotype and phenotype of mosaic NF2 after improving the diagnostic rate of mosaic NF2. METHODS We performed targeted deep sequencing of 36 genes including NF2 using DNA samples from multiple tissues (blood, buccal mucosa, hair follicle and tumour) of 53 patients with de novo NF2 and elucidated their genotype-phenotype correlation. RESULTS Twenty-four patients (45.2%) had the NF2 germline variant, and 20 patients with NF2 (37.7%) had mosaic NF2. The mosaic NF2 phenotype was significantly different from that in patients with NF2 germline variant in terms of distribution of NF2-related disease, tumour growth rate and hearing outcome. The behaviour of schwannoma correlated to the extent of VAF with NF2 variant in normal tissues unlike meningioma. CONCLUSION We have improved the diagnostic rate of mosaic NF2 compared with that of previous studies by targeted deep sequencing of DNA from multiple tissues. Many atypical patients with NF2 diagnosed with 'unilateral vestibular schwannoma' or 'multiple meningiomas' presumably have mosaic NF2. Finally, we suggest that the highly diverse phenotype of NF2 could result not only from the type and location of NF2 variant but also the extent of VAF in the NF2 variant within normal tissue DNA.
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Affiliation(s)
- Yu Teranishi
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroki Hongo
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shogo Dofuku
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Atsushi Okano
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shunsaku Takayanagi
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahiro Ota
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Jun Yoshimura
- Department of Computational Biology and Medical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Wei Qu
- Department of Computational Biology and Medical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jun Mitsui
- Department of Molecular Neurology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hirofumi Nakatomi
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shinichi Morishita
- Department of Computational Biology and Medical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shoji Tsuji
- Department of Molecular Neurology, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Shao Z, Liu L, Zheng Y, Tu S, Pan Y, Yan S, Wei Q, Shao A, Zhang J. Molecular Mechanism and Approach in Progression of Meningioma. Front Oncol 2020; 10:538845. [PMID: 33042832 PMCID: PMC7518150 DOI: 10.3389/fonc.2020.538845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022] Open
Abstract
Meningioma is the most common tumor of the central nervous system, most of which is benign. Even after complete resection, a high rate of recurrence of meningioma is observed. From in-depth study of its pathogenesis, it has been found that a number of chromosomal variations and abnormal molecular signals are closely related to the occurrence and development of malignancy in meningioma, which may provide the theoretical basis and potential direction for accurate and targeted treatment. We have reviewed advances in chromosomal variations and molecular mechanisms involved in the progression of meningioma, and have highlighted the association with malignant biological behavior including cell proliferation, angiogenesis, increased invasiveness, and inhibition of apoptosis. In addition, the chemotherapy of meningioma is summarized and discussed.
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Affiliation(s)
- Zhiwei Shao
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lihong Liu
- Department of Radiation Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanghao Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Sheng Tu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanbo Pan
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sheng Yan
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qichun Wei
- Department of Radiation Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Anwen Shao
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China.,Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, China
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Identification of a Transcription Factor-microRNA-Gene Coregulation Network in Meningioma through a Bioinformatic Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6353814. [PMID: 32832554 PMCID: PMC7428944 DOI: 10.1155/2020/6353814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/04/2020] [Accepted: 07/18/2020] [Indexed: 12/20/2022]
Abstract
Background Meningioma is a prevalent type of brain tumor. However, the initiation and progression mechanisms involved in the meningioma are mostly unknown. This study aimed at exploring the potential transcription factors/micro(mi)RNAs/genes and biological pathways associated with meningioma. Methods mRNA expressions from GSE88720, GSE43290, and GSE54934 datasets, containing data from 83 meningioma samples and eight control samples, along with miRNA expression dataset GSE88721, which had 14 meningioma samples and one control sample, were integrated analyzed. The bioinformatics approaches were used for identifying differentially expressed genes and miRNAs, as well as predicting transcription factor targets related to the differentially expressed genes. The approaches were also used for gene ontology term analysis and biological pathway enrichment analysis, construction, and analysis of protein-protein interaction network, and transcription factor-miRNA-gene coregulation network construction. Results Fifty-six upregulated and 179 downregulated genes were identified. Thirty transcription factors able to target the differentially expressed genes were predicted and selected based on public databases. One hundred seventeen overlapping genes were identified from the differentially expressed genes and the miRNAs predicted by miRWalk. Furthermore, NF-κB/IL6, PTGS2, MYC/hsa-miR-574-5p, hsa-miR-26b-5p, hsa-miR-335-5p, and hsa-miR-98-5p, which are involved in the transcription factor-miRNA-mRNA coregulation network, were found to be associated with meningioma. Conclusion The bioinformatics analysis identified several potential molecules and relevant pathways that may represent critical mechanisms involved in the progression and development of meningioma. This work provides new insights into meningioma pathogenesis and treatments.
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Lyons Rimmer J, Ercolano E, Baiz D, Makhija M, Berger A, Sells T, Stroud S, Hilton D, Adams CL, Hanemann CO. The Potential of MLN3651 in Combination with Selumetinib as a Treatment for Merlin-Deficient Meningioma. Cancers (Basel) 2020; 12:cancers12071744. [PMID: 32629964 PMCID: PMC7407567 DOI: 10.3390/cancers12071744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022] Open
Abstract
Meningioma is the most common primary intracranial tumour, and surgical resection is the main therapeutic option. Merlin is a tumour suppressor protein that is frequently mutated in meningioma. The activity of the E3 ubiquitin ligase complex, CRL4-DCAF1, and the Raf/MEK/ERK scaffold protein Kinase suppressor of Ras 1 (KSR1) are upregulated in Merlin-deficient tumours, which drives tumour growth. Identifying small molecules that inhibit these key pathways may provide an effective treatment option for patients with meningioma. We used meningioma tissue and primary cells derived from meningioma tumours to investigate the expression of DDB1 and Cullin 4-associated factor 1 (DCAF1) and KSR1, and confirmed these proteins were overexpressed. We then used primary cells to assess the therapeutic potential of MLN3651, a neddylation inhibitor which impacts the activity of the CRL family of E3 ubiquitin ligases and the MAPK/ERK kinase (MEK1/2) inhibitor selumetinib. MLN3651 treatment reduced proliferation and activated apoptosis, whilst increasing Raf/MEK/ERK pathway activation. The combination of MLN3651 and the MEK1/2 inhibitor selumetinib prevented the increase in Raf/MEK/ERK activity, and had an additive effect compared with either treatment alone. Therefore, the combined targeting of CRL4-DCAF1 and Raf/MEK/ERK activity represents an attractive novel strategy in the treatment of Merlin-deficient meningioma.
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Affiliation(s)
- Jade Lyons Rimmer
- Peninsula Schools of Medicine and Dentistry, Institute of Translational and Stratified Medicine, Plymouth University, Plymouth PL68BU, UK; (J.L.R.); (E.E.); (D.B.); (C.L.A.)
| | - Emanuela Ercolano
- Peninsula Schools of Medicine and Dentistry, Institute of Translational and Stratified Medicine, Plymouth University, Plymouth PL68BU, UK; (J.L.R.); (E.E.); (D.B.); (C.L.A.)
| | - Daniele Baiz
- Peninsula Schools of Medicine and Dentistry, Institute of Translational and Stratified Medicine, Plymouth University, Plymouth PL68BU, UK; (J.L.R.); (E.E.); (D.B.); (C.L.A.)
| | | | - Allison Berger
- Millennium Pharmaceuticals, Inc. a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA 02139, USA; (A.B.); (T.S.); (S.S.)
| | - Todd Sells
- Millennium Pharmaceuticals, Inc. a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA 02139, USA; (A.B.); (T.S.); (S.S.)
| | - Steve Stroud
- Millennium Pharmaceuticals, Inc. a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA 02139, USA; (A.B.); (T.S.); (S.S.)
| | - David Hilton
- Department of Histopathology, University Hospitals Plymouth NHS Trust, Plymouth, Devon PL6 8DH, UK;
| | - Claire L. Adams
- Peninsula Schools of Medicine and Dentistry, Institute of Translational and Stratified Medicine, Plymouth University, Plymouth PL68BU, UK; (J.L.R.); (E.E.); (D.B.); (C.L.A.)
| | - C Oliver Hanemann
- Peninsula Schools of Medicine and Dentistry, Institute of Translational and Stratified Medicine, Plymouth University, Plymouth PL68BU, UK; (J.L.R.); (E.E.); (D.B.); (C.L.A.)
- Correspondence: ; Tel.: +44-1752-437-418
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Sacco S, Ballati F, Gaetani C, Lomoro P, Farina LM, Bacila A, Imparato S, Paganelli C, Buizza G, Iannalfi A, Baroni G, Valvo F, Bastianello S, Preda L. Multi-parametric qualitative and quantitative MRI assessment as predictor of histological grading in previously treated meningiomas. Neuroradiology 2020; 62:1441-1449. [PMID: 32583368 DOI: 10.1007/s00234-020-02476-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/10/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Meningiomas are mainly benign tumors, though a considerable proportion shows aggressive behaviors histologically consistent with atypia/anaplasia. Histopathological grading is usually assessed through invasive procedures, which is not always feasible due to the inaccessibility of the lesion or to treatment contraindications. Therefore, we propose a multi-parametric MRI assessment as a predictor of meningioma histopathological grading. METHODS Seventy-three patients with 74 histologically proven and previously treated meningiomas were retrospectively enrolled (42 WHO I, 24 WHO II, 8 WHO III) and studied with MRI including T2 TSE, FLAIR, Gradient Echo, DWI, and pre- and post-contrast T1 sequences. Lesion masks were segmented on post-contrast T1 sequences and rigidly registered to ADC maps to extract quantitative parameters from conventional DWI and intravoxel incoherent motion model assessing tumor perfusion. Two expert neuroradiologists assessed morphological features of meningiomas with semi-quantitative scores. RESULTS Univariate analysis showed different distributions (p < 0.05) of quantitative diffusion parameters (Wilcoxon rank-sum test) and morphological features (Pearson's chi-square; Fisher's exact test) among meningiomas grouped in low-grade (WHO I) and higher grade forms (WHO II/III); the only exception consisted of the tumor-brain interface. A multivariate logistic regression, combining all parameters showing statistical significance in the univariate analysis, allowed discrimination between the groups of meningiomas with high sensitivity (0.968) and specificity (0.925). Heterogeneous contrast enhancement and low ADC were the best independent predictors of atypia and anaplasia. CONCLUSION Our multi-parametric MRI assessment showed high sensitivity and specificity in predicting histological grading of meningiomas. Such an assessment may be clinically useful in characterizing lesions without histological diagnosis. Key points • When surgery and biopsy are not feasible, parameters obtained from both conventional and diffusion-weighted MRI can predict atypia and anaplasia in meningiomas with high sensitivity and specificity. • Low ADC values and heterogeneous contrast enhancement are the best predictors of higher grade meningioma.
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Affiliation(s)
- Simone Sacco
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Francesco Ballati
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Clara Gaetani
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Pascal Lomoro
- Department of Radiology, Valduce Hospital, Como, Italy
| | | | - Ana Bacila
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Sara Imparato
- Diagnostic Imaging Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100, Pavia, PV, Italy
| | - Chiara Paganelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Giulia Buizza
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Alberto Iannalfi
- Radiotherapy Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Guido Baroni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
- Bioengineering Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Francesca Valvo
- Radiotherapy Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Stefano Bastianello
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Lorenzo Preda
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
- Diagnostic Imaging Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100, Pavia, PV, Italy.
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Helgager J, Driver J, Hoffman S, Bi WL. Molecular Advances in Central Nervous System Mesenchymal Tumors. Surg Pathol Clin 2020; 13:291-303. [PMID: 32389268 DOI: 10.1016/j.path.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mesenchymal tumors of the central nervous system (CNS) comprise an array of neoplasms that may arise from or secondarily affect the CNS and its immediate surroundings. This review focuses on meningiomas and solitary fibrous tumors, the most common primary CNS mesenchymal tumors, and discusses recent advances in unveiling the molecular landscapes of these neoplasms. An effort is made to underscore those molecular findings most relevant to tumor diagnostics and prognostication from a practical perspective. As molecular techniques become more readily used at the clinical level, such alterations may strengthen formal grading schemes and lend themselves to treatment with targeted therapies.
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Affiliation(s)
- Jeffrey Helgager
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph Driver
- Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Samantha Hoffman
- Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wenya Linda Bi
- Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Brenner AV, Sugiyama H, Preston DL, Sakata R, French B, Sadakane A, Cahoon EK, Utada M, Mabuchi K, Ozasa K. Radiation risk of central nervous system tumors in the Life Span Study of atomic bomb survivors, 1958-2009. Eur J Epidemiol 2020; 35:591-600. [PMID: 31982981 PMCID: PMC7329623 DOI: 10.1007/s10654-019-00599-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
Radiation exposure is among the few factors known to be associated with risk of central nervous system (CNS) tumors. However, the patterns of radiation risk by histological type, sex or age are unclear. We evaluated radiation risks of first primary glioma, meningioma, schwannoma, and other or not otherwise specified (other/NOS) tumors in the Life Span Study cohort of atomic bomb survivors. Cases diagnosed between 1958 and 2009 were ascertained through population-based cancer registries in Hiroshima and Nagasaki. To estimate excess relative risk per Gy (ERR/Gy), we fit rate models using Poisson regression methods. There were 285 CNS tumors (67 gliomas, 107 meningiomas, 49 schwannomas, and 64 other/NOS tumors) among 105,444 individuals with radiation dose estimates to the brain contributing 3.1 million person-years of observation. Based on a simple linear model without effect modification, ERR/Gy was 1.67 (95% confidence interval, CI: 0.12 to 5.26) for glioma, 1.82 (95% CI: 0.51 to 4.30) for meningioma, 1.45 (95% CI: - 0.01 to 4.97) for schwannoma, and 1.40 (95% CI: 0.61 to 2.57) for all CNS tumors as a group. For each tumor type, the dose-response was consistent with linearity and appeared to be stronger among males than among females, particularly for meningioma (P = 0.045). There was also evidence that the ERR/Gy for schwannoma decreased with attained age (P = 0.002). More than 60 years after the bombings, radiation risks for CNS tumors continue to be elevated. Further follow-up is necessary to characterize the lifetime risks of specific CNS tumors following radiation exposure.
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Affiliation(s)
- Alina V Brenner
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan.
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| | | | - Ritsu Sakata
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| | - Benjamin French
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| | - Atsuko Sadakane
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mai Utada
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| | - Kiyohiko Mabuchi
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kotaro Ozasa
- Radiation Effects Research Foundation, Epidemiology, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
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The Hippo Pathway as a Driver of Select Human Cancers. Trends Cancer 2020; 6:781-796. [PMID: 32446746 DOI: 10.1016/j.trecan.2020.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022]
Abstract
The Hippo pathway regulates myriad biological processes in diverse species and is a key cancer signaling network in humans. Although Hippo has been linked to multiple aspects of cancer, its role in this disease is incompletely understood. Large-scale pan-cancer analyses of core Hippo pathway genes reveal that the pathway is mutated at a high frequency only in select human cancers, including malignant mesothelioma and meningioma. Hippo pathway deregulation is also enriched in squamous epithelial cancers. We discuss cancer-related functions of the Hippo pathway and potential explanations for the cancer-restricted mutation profile of core Hippo pathway genes. Greater understanding of Hippo pathway deregulation in cancers will be essential to guide the imminent use of Hippo-targeted therapies.
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Bhambhvani HP, Rodrigues AJ, Medress ZA, Hayden Gephart M. Racial and socioeconomic correlates of treatment and survival among patients with meningioma: a population-based study. J Neurooncol 2020; 147:495-501. [PMID: 32193691 DOI: 10.1007/s11060-020-03455-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/07/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Though meningioma is the most common primary brain tumor, there is a paucity of epidemiologic studies investigating disparities in treatment and patient outcomes. Therefore, we sought to explore how sociodemographic factors are associated with rates of gross total resection (GTR) and radiotherapy as well as survival. METHODS The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was queried to identify adult patients with meningioma diagnosed between 2005 and 2015. Socioeconomic status (SES) was determined using a validated composite index in which patients were stratified into tertiles and quintiles. Multivariable logistic regression and Cox proportional hazards analyses were used to identify predictors of treatment and survival, respectively. RESULTS 71,098 patients met our inclusion criteria. Low SES quintile was associated with reduced odds of receiving GTR (OR 0.76, 95% CI 0.69-0.83, p < 0.0001) and radiotherapy (OR 0.83, 95% CI 0.76-0.91, p < 0.0001) as well as worse survival (HR 1.48, 95% CI 1.41-1.56) as compared to the highest SES quintile. Black patients had reduced odds of GTR (OR 0.74, 95% CI 0.67-0.71, p < 0.0001) and worse survival (HR 1.23, 95% CI 1.18-1.29, p < 0.0001) as compared to white patients. CONCLUSIONS This national study of patients with meningioma found socioeconomic status and race to be independent inverse correlates of likelihood of GTR, radiotherapy, and survival. Limited access to care may underlie these disparities in part, and future studies are warranted to identify specific causes for these findings.
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Lee YS, Lee YS. Molecular characteristics of meningiomas. J Pathol Transl Med 2020; 54:45-63. [PMID: 31964111 PMCID: PMC6986967 DOI: 10.4132/jptm.2019.11.05] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Abstract
Meningioma is the most common primary intracranial tumor in adults. The grading of meningioma is based on World Health Organization criteria, which rely on histopathological features alone. This grading system is unable to conclusively predict the clinical behavior of these tumors (i.e., recurrence or prognosis in benign or atypical grades). Advances in molecular techniques over the last decade that include genomic and epigenomic data associated with meningiomas have been used to identify genetic biomarkers that can predict tumor behavior. This review summarizes the molecular characteristics of meningioma using genetic and epigenetic biomarkers. Molecular alterations that can predict meningioma behavior may be integrated into the upcoming World Health Organization grading system.
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Affiliation(s)
- Young Suk Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn Soo Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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