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Trybula SJ, Youngblood MW, Karras CL, Murthy NK, Heimberger AB, Lukas RV, Sachdev S, Kalapurakal JA, Chandler JP, Brat DJ, Horbinski CM, Magill ST. The Evolving Classification of Meningiomas: Integration of Molecular Discoveries to Inform Patient Care. Cancers (Basel) 2024; 16:1753. [PMID: 38730704 PMCID: PMC11083836 DOI: 10.3390/cancers16091753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Meningioma classification and treatment have evolved over the past eight decades. Since Bailey, Cushing, and Eisenhart's description of meningiomas in the 1920s and 1930s, there have been continual advances in clinical stratification by histopathology, radiography and, most recently, molecular profiling, to improve prognostication and predict response to therapy. Precise and accurate classification is essential to optimizing management for patients with meningioma, which involves surveillance imaging, surgery, primary or adjuvant radiotherapy, and consideration for clinical trials. Currently, the World Health Organization (WHO) grade, extent of resection (EOR), and patient characteristics are used to guide management. While these have demonstrated reliability, a substantial number of seemingly benign lesions recur, suggesting opportunities for improvement of risk stratification. Furthermore, the role of adjuvant radiotherapy for grade 1 and 2 meningioma remains controversial. Over the last decade, numerous studies investigating the molecular drivers of clinical aggressiveness have been reported, with the identification of molecular markers that carry clinical implications as well as biomarkers of radiotherapy response. Here, we review the historical context of current practices, highlight recent molecular discoveries, and discuss the challenges of translating these findings into clinical practice.
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Affiliation(s)
- S. Joy Trybula
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Mark W. Youngblood
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Constantine L. Karras
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Nikhil K. Murthy
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Amy B. Heimberger
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Rimas V. Lukas
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Sean Sachdev
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - John A. Kalapurakal
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - James P. Chandler
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Daniel J. Brat
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Craig M. Horbinski
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Stephen T. Magill
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Tomanelli M, Florio T, Vargas GC, Pagano A, Modesto P. Domestic Animal Models of Central Nervous System Tumors: Focus on Meningiomas. Life (Basel) 2023; 13:2284. [PMID: 38137885 PMCID: PMC10744527 DOI: 10.3390/life13122284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023] Open
Abstract
Intracranial primary tumors (IPTs) are aggressive forms of malignancies that cause high mortality in both humans and domestic animals. Meningiomas are frequent adult IPTs in humans, dogs, and cats, and both benign and malignant forms cause a decrease in life quality and survival. Surgery is the primary therapeutic approach to treat meningiomas, but, in many cases, it is not resolutive. The chemotherapy and targeted therapy used to treat meningiomas also display low efficacy and many side effects. Therefore, it is essential to find novel pharmacological approaches to increase the spectrum of therapeutic options for meningiomas. This review analyzes the similarities between human and domestic animal (dogs and cats) meningiomas by evaluating the molecular and histological characteristics, diagnosis criteria, and treatment options and highlighting possible research areas to identify novel targets and pharmacological approaches, which are useful for the diagnosis and therapy of this neoplasia to be used in human and veterinary medicine.
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Affiliation(s)
- Michele Tomanelli
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
| | - Tullio Florio
- Pharmacology Section, Department of Internal Medicine (DIMI), University of Genova, 16126 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Gabriela Coronel Vargas
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
| | - Aldo Pagano
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy; (G.C.V.); (A.P.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Paola Modesto
- National Reference Center for Veterinary and Comparative Oncology, Veterinary Medical Research Institute for Piemonte, Liguria and Valle d’Aosta, 10154 Torino, Italy
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Tatman PD, Wroblewski TH, Fringuello AR, Scherer SR, Foreman WB, Damek DM, Youssef AS, Lillehei KO, Jensen RL, Graner MW, Ormond DR. High-Throughput Screening of Epigenetic Inhibitors in Meningiomas Identifies HDAC, G9a, and Jumonji-Domain Inhibition as Potential Therapies. J Neurol Surg B Skull Base 2023; 84:452-462. [PMID: 37671294 PMCID: PMC10477014 DOI: 10.1055/a-1885-1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022] Open
Abstract
Background Epigenetics may predict treatment sensitivity and clinical course for patients with meningiomas more accurately than histopathology. Nonetheless, targeting epigenetic mechanisms is understudied for pharmacotherapeutic development for these tumors. The bio-molecular insights and potential therapeutic development of meningioma epigenetics led us to investigate epigenetic inhibition in meningiomas. Methods We screened a 43-tumor cohort using a 139-compound epigenetic inhibitor library to assess sensitivity of relevant meningioma subgroups to epigenetic inhibition. The cohort was composed of 5 cell lines and 38 tumors cultured directly from surgery; mean patient age was 56.6 years ± 13.9 standard deviation. Tumor categories: 38 primary tumors, 5 recurrent; 33 from females, 10 from males; 32 = grade 1; 10 = grade 2; 1 = grade 3. Results Consistent with our previous results, histone deacetylase inhibitors (HDACi) were the most efficacious class. Panobinostat significantly reduced cell viability in 36 of 43 tumors; 41 tumors had significant sensitivity to some HDACi. G9a inhibition and Jumonji-domain inhibition also significantly reduced cell viability across the cohort; tumors that lost sensitivity to panobinostat maintained sensitivity to either G9a or Jumonji-domain inhibition. Sensitivity to G9a and HDAC inhibition increased with tumor grade; tumor responses did not separate by gender. Few differences were found between recurrent and primary tumors, or between those with prior radiation versus those without. Conclusions Few efforts have investigated the efficacy of targeting epigenetic mechanisms to treat meningiomas, making the clinical utility of epigenetic inhibition largely unknown. Our results suggest that epigenetic inhibition is a targetable area for meningioma pharmacotherapy.
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Affiliation(s)
- Philip D. Tatman
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Medical Scientist Training Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Department of Pharmacology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Tadeusz H. Wroblewski
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Anthony R. Fringuello
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Samuel R. Scherer
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - William B. Foreman
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Denise M. Damek
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - A. Samy Youssef
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kevin O. Lillehei
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - Randy L. Jensen
- Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States
| | - Michael W. Graner
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
| | - D. Ryan Ormond
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
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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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Shen Y, Liu X, Yang W. Angiomatous meningioma with bizarre nuclei: A case report. Mol Clin Oncol 2023; 18:46. [PMID: 37206430 PMCID: PMC10189420 DOI: 10.3892/mco.2023.2642] [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: 12/23/2022] [Accepted: 03/31/2023] [Indexed: 05/21/2023] Open
Abstract
Angiomatous meningioma (AM) is a relatively rare subtype of WHO grade I meningioma. A relatively rare case of AM was recently encountered in a 45-year-old woman. The present case not only observed the typical AM histological pattern but also a large number of cells with bizarre, large, deeply staining and unevenly distributed nuclei. These cells with bizarre nuclei showed a similar pattern of immunoreactivity as meningeal epithelial cells. Although the presence of a large number of cells with bizarre nuclei in this case increased tumour cell atypia, the cells did not differ with regard to proliferative activity and mitotic imaging. Therefore, the patient was ultimately diagnosed as having AM with bizarre nuclei, WHO grade I. This manifestation of nuclear atypia and pleomorphism may be due to 'degenerative changes' in pre-existing, long-established vascular lesions, similar to those seen in degenerative schwannomas and symplastic haemangioma, rather than being considered an indicator of malignancy.
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Affiliation(s)
- Yanling Shen
- Department of Pathology, Army 73rd Group Military Hospital of PLA and Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian 361000, P.R. China
| | - Xueqing Liu
- Department of Pathology, Army 73rd Group Military Hospital of PLA and Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian 361000, P.R. China
| | - Wensheng Yang
- Department of Pathology, Army 73rd Group Military Hospital of PLA and Xiamen University Affiliated Chenggong Hospital, Xiamen, Fujian 361000, P.R. China
- Correspondence to: Mr. Wensheng Yang, Department of Pathology, Army 73rd Group Military Hospital of PLA and Xiamen University Affiliated Chenggong Hospital, 94 Wenyuan Road, Xiamen, Fujian 361000, P.R. China
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Dullea JT, Chaluts D, Vasan V, Rutland JW, Gill CM, Ellis E, Kinoshita Y, McBride RB, Bederson J, Donovan M, Sebra R, Umphlett M, Shrivastava RK. NF2 mutation associated with accelerated time to recurrence for older patients with atypical meningiomas. Br J Neurosurg 2023:1-7. [PMID: 37096420 PMCID: PMC10598238 DOI: 10.1080/02688697.2023.2204927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Meningiomas occur more frequently in older adults, with the incidence rates increasing from 5.8/100,000 for adults 35-44 years old to 55.2/100,000 for those 85+. Due to the increased risk of surgical management in older adults, there is a need to characterize the risk factors for aggressive disease course to inform management decisions in this population. We therefore sought to determine age-stratified relationships between tumour genomics and recurrence after resection of atypical meningiomas. METHODS We identified 137 primary and recurrent Grade 2 meningiomas from our existing meningioma genomic sequencing database. We examined the differential distribution of genomic alterations in those older than 65 compared to younger. We then performed an age stratified survival analysis to model recurrence for a mutation identified as differentially present. RESULTS In our cohort of 137 patients with grade 2 meningiomas, alterations in NF2 were present at a higher rate in older adults compared to younger (37.8% in < 65 vs. 55.3% in > 65; recurrence adjusted p-value =0.04). There was no association between the presence of NF2 and recurrence in the whole cohort. In the age-stratified model for those less than 65 years old, there was again no relationship. For patients in the older age stratum, there is a relationship between NF2 and worsened recurrence outcomes (HR = 3.64 (1.125 - 11.811); p = 0.031). CONCLUSIONS We found that mutations in NF2 were more common in older adults. Further, the presence of mutant NF2 was associated with an increased risk of recurrence in older adults.
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Affiliation(s)
- Jonathan T. Dullea
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Danielle Chaluts
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Vikram Vasan
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - John W. Rutland
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Corey M. Gill
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Ethan Ellis
- Department of Genetics and Genomic Sciences, Icahn School
of Medicine at Mount Sinai, New York, NY
| | - Yayoi Kinoshita
- Department of Pathology, Icahn School of Medicine at Mount
Sinai, New York, NY
| | - Russell B. McBride
- Department of Pathology, Icahn School of Medicine at Mount
Sinai, New York, NY
- The Institute for Translational Epidemiology, Icahn School
of Medicine at Mount Sinai, New York, NY
| | - Joshua Bederson
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Michael Donovan
- Department of Pathology, Icahn School of Medicine at Mount
Sinai, New York, NY
| | - Robert Sebra
- Department of Genetics and Genomic Sciences, Icahn School
of Medicine at Mount Sinai, New York, NY
- Sema4, A Mount Sinai venture, Stamford, CT
| | - Melissa Umphlett
- Department of Pathology, Icahn School of Medicine at Mount
Sinai, New York, NY
| | - Raj K. Shrivastava
- Department of Neurosurgery, Icahn School of Medicine at
Mount Sinai, New York, NY
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Franca RA, Della Monica R, Corvino S, Chiariotti L, Del Basso De Caro M. WHO grade and pathological markers of meningiomas: Clinical and prognostic role. Pathol Res Pract 2023; 243:154340. [PMID: 36738518 DOI: 10.1016/j.prp.2023.154340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
In recent years, WHO grading criteria have emerged as an inaccurate tool to correctly predict the risk of progression/recurrence for meningioma patients. Therefore, great efforts were made to find further prognostic factors that could predict the clinical course of meningiomas. Why morphological criteria are not able alone to correctly predict outcome in all patients? What are the biological parameters underlying a more aggressive behavior? Are there any molecular markers can be integrated in the risk assessment? Could new technologies, such as methylome profiling, contribute to provide additional tools in patients prognostic evaluation? We performed a literature review to find answers to these questions. Meningiomas have been demonstrated to be extremely heterogeneous neoplasms, also from the genetic and epigenetic standpoints. However, WHO Classification of Tumours of the central Nervous System 5th edition introduced only CDKN2A/B deletion and TERT promoter mutations as poor prognostic, grade 3 defining parameters. The different proposals of integrated grading, taking into account cytogenetic alterations and study of methylation profile, have not yet been incorporated in WHO grading criteria. Work in progress: this is the summary of current knowledge. Further studies are needed to expand the diagnostic and prognostic equipment to be integrated into clinical practice.
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Affiliation(s)
- Raduan Ahmed Franca
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy.
| | - Rosa Della Monica
- CEINGE Biotecnologie Avanzate scarl, via Gaetano Salvatore, 486, Naples, Italy.
| | - Sergio Corvino
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università di Napoli Federico II, Naples 80131, Italy.
| | - Lorenzo Chiariotti
- CEINGE Biotecnologie Avanzate scarl, via Gaetano Salvatore, 486, Naples, Italy.
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy.
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Wang EJ, Haddad AF, Young JS, Morshed RA, Wu JPH, Salha DM, Butowski N, Aghi MK. Recent advances in the molecular prognostication of meningiomas. Front Oncol 2023; 12:910199. [PMID: 36686824 PMCID: PMC9845914 DOI: 10.3389/fonc.2022.910199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/17/2022] [Indexed: 01/05/2023] Open
Abstract
Meningiomas are the most common primary intracranial neoplasm. While traditionally viewed as benign, meningiomas are associated with significant patient morbidity, and certain meningioma subgroups display more aggressive and malignant behavior with higher rates of recurrence. Historically, the risk stratification of meningioma recurrence has been primarily associated with the World Health Organization histopathological grade and surgical extent of resection. However, a growing body of literature has highlighted the value of utilizing molecular characteristics to assess meningioma aggressiveness and recurrence risk. In this review, we discuss preclinical and clinical evidence surrounding the use of molecular classification schemes for meningioma prognostication. We also highlight how molecular data may inform meningioma treatment strategies and future directions.
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Affiliation(s)
- Elaina J. Wang
- Department of Neurological Surgery, Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Alexander F. Haddad
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Ramin A. Morshed
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Joshua P. H. Wu
- Department of Neurological Surgery, Brown University, Rhode Island Hospital, Providence, RI, United States
| | - Diana M. Salha
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Manish K. Aghi
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States,*Correspondence: Manish K. Aghi,
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Wang JZ, Nassiri F, Mawrin C, Zadeh G. Genomic Landscape of Meningiomas. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1416:137-158. [PMID: 37432625 DOI: 10.1007/978-3-031-29750-2_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Despite being the most common primary brain tumor in adults, until recently, the genomics of meningiomas have remained quite understudied. In this chapter we will discuss the early cytogenetic and mutational changes uncovered in meningiomas, from the discovery of the loss of chromosome 22q and the neurofibromatosis-2 (NF2) gene to other non-NF2 driver mutations (KLF4, TRAF7, AKT1, SMO, etc.) discovered using next generation sequencing. We discuss each of these alterations in the context of their clinical significance and conclude the chapter by reviewing recent multiomic studies that have integrated our knowledge of these alterations together to develop novel molecular classifications for meningiomas.
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Affiliation(s)
- Justin Z Wang
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, The University of Toronto, Toronto, ON, Canada
| | - Farshad Nassiri
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, The University of Toronto, Toronto, ON, Canada
| | - Christian Mawrin
- Department of Neuropathology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Gelareh Zadeh
- MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, ON, Canada.
- Division of Neurosurgery, Department of Surgery, The University of Toronto, Toronto, ON, Canada.
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Go KO, Kim YZ. Brain Invasion and Trends in Molecular Research on Meningioma. Brain Tumor Res Treat 2023; 11:47-58. [PMID: 36762808 PMCID: PMC9911709 DOI: 10.14791/btrt.2022.0044] [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: 12/11/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Meningiomas are the most common primary brain tumors in adults. The treatment of non-benign meningiomas remains a challenging task, and after the publication of the 2021 World Health Organization classification, the importance of molecular biological classification is emerging. In this article, we introduce the mechanisms of brain invasion in atypical meningioma and review the genetic factors involved along with epigenetic regulation. First, it is important to understand the three major steps for brain invasion of meningeal cells: 1) degradation of extracellular matrix by proteases, 2) promotion of tumor cell migration to resident cells by adhesion molecules, and 3) neovascularization and supporting cells by growth factors. Second, the genomic landscape of meningiomas should be analyzed by major categories, such as germline mutations in NF2 and somatic mutations in non-NF2 genes (TRAF7, KLF4, AKT1, SMO, and POLR2A). Finally, epigenetic alterations in meningiomas are being studied, with a focus on DNA methylation, histone modification, and RNA interference. Increasing knowledge of the molecular landscape of meningiomas has allowed the identification of prognostic and predictive markers that can guide therapeutic decision-making processes and the timing of follow-up.
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Affiliation(s)
- Kyeong-O Go
- Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Young Zoon Kim
- Division of Neuro Oncology and Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
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Lee SH, Lee EH, Sung KS, Kim DC, Kim YZ, Song YJ. Ki67 index is the most powerful factor for predicting the recurrence in atypical meningioma: Retrospective analysis of 99 patients in two institutes. J Korean Neurosurg Soc 2022; 65:558-571. [PMID: 35418005 PMCID: PMC9271814 DOI: 10.3340/jkns.2021.0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/18/2021] [Indexed: 11/29/2022] Open
Abstract
Objective The primary objective of this study was to identify predicting factors for local control (LC) of atypical meningioma, and we validated them with comparing the predicting factors for recurrence-free survival (RFS). We also examined the rate of LC after surgical resection with or without adjuvant treatment and RFS.
Methods Clinical and radiological records of patients with atypical meningiomas diagnosed at two institutes from January 2000 to December 2018 were reviewed retrospectively. Histopathological features were also reviewed using formalin-fixed paraffin embedded samples from pathological archives.
Results Of the 99 atypical meningiomas eligible for analysis, 36 (36.4%) recurred during the follow-up period (mean, 83.3 months; range, 12–232 months). The rate of 3-year LC and 5-year LC was 80.8% and 74.7%, respectively. The mean time-to-recurrence was 49.4 months (range, 12–150). The mean RFS was 149.3 months (95% confidence interval, 128.8–169.8 months) during the mean follow-up duration of 83.3 months (range, 12–232 months). Multivariate analysis using Cox proportional-hazard regression model showed that the extent of resection (hazard ratio [HR], 4.761; p=0.013), Ki67 index (HR, 8.541; p=0.004), mitotic index (HR, 3.275; p=0.044), and tumor size (HR, 3.228; p=0.041) were independently associated with LC. These factors were also statistically associated with RFS. In terms of radiotherapy after surgical resection, the recurrence was not prevented by immediate radiotherapy because of the strong effect of proliferative index on recurrence.
Conclusion The present study suggests that the extent of resection, proliferative index (according to Ki67 expression) and mitotic index, and tumor size are associated with recurrence of atypical meningiomas. However, our results should be further validated through prospective and randomized clinical trials to overcome the inborn bias of retrospective nature of the study design.
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Affiliation(s)
- Sang Hyuk Lee
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Eun Hee Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Kyoung Su Sung
- Department of Neurosurgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Dae Cheol Kim
- Department of Pathology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Young Zoon Kim
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Young Jin Song
- Department of Neurosurgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea
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da Silva CE, Zanatta C, Thibes AC, Vidaletti T. SPHENOID WING MENINGIOMAS WITH SECONDARY CAVERNOUS SINUS INVASION: SURGICAL RESULTS AND ALGORITHM FOR TREATMENT AT A SINGLE BRAZILIAN CENTER. World Neurosurg 2022; 163:e635-e646. [DOI: 10.1016/j.wneu.2022.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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13
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Patel B, Desai R, Pugazenthi S, Butt OH, Huang J, Kim AH. Identification and Management of Aggressive Meningiomas. Front Oncol 2022; 12:851758. [PMID: 35402234 PMCID: PMC8984123 DOI: 10.3389/fonc.2022.851758] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/23/2022] [Indexed: 12/31/2022] Open
Abstract
Meningiomas are common primary central nervous system tumors derived from the meninges, with management most frequently entailing serial monitoring or a combination of surgery and/or radiation therapy. Although often considered benign lesions, meningiomas can not only be surgically inaccessible but also exhibit aggressive growth and recurrence. In such cases, adjuvant radiation and systemic therapy may be required for tumor control. In this review, we briefly describe the current WHO grading scale for meningioma and provide demonstrative cases of treatment-resistant meningiomas. We also summarize frequently observed molecular abnormalities and their correlation with intracranial location and recurrence rate. We then describe how genetic and epigenetic features might supplement or even replace histopathologic features for improved identification of aggressive lesions. Finally, we describe the role of surgery, radiotherapy, and ongoing systemic therapy as well as precision medicine clinical trials for the treatment of recurrent meningioma.
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Affiliation(s)
- Bhuvic Patel
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Rupen Desai
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Sangami Pugazenthi
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Omar H. Butt
- Department of Medicine, Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, United States,The Brain Tumor Center, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States
| | - Jiayi Huang
- The Brain Tumor Center, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States,Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, United States
| | - Albert H. Kim
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States,The Brain Tumor Center, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States,*Correspondence: Albert H. Kim,
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Kumthekar P, Grimm SA, Aleman RT, Chamberlain MC, Schiff D, Wen PY, Iwamoto FM, Gursel DB, Reardon DA, Purow B, Kocherginski M, Helenowski I, Raizer JJ. A multi-institutional phase II trial of bevacizumab for recurrent and refractory meningioma. Neurooncol Adv 2022; 4:vdac123. [PMID: 36225651 PMCID: PMC9549880 DOI: 10.1093/noajnl/vdac123] [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] [Indexed: 11/12/2022] Open
Abstract
Background Systemic therapies for refractory meningiomas are limited with no FDA-approved therapeutics. Vascular endothelial growth factor (VEGF) is a signaling protein associated with neovascularization, peritumoral edema, and meningioma tumorigenesis. Methods This phase II study investigates the efficacy of bevacizumab (BEV), a VEGF binding monoclonal antibody, in patients with progressive Grade I (G1M), Grade II (G2M), Grade III (G3M) meningioma, and other non-parenchymal tumors including vestibular schwannoma (n = 4) and hemangiopericytoma (n = 4) with the primary endpoint of progression-free survival rate at 6-months (PFS-6). Non-meningiomas were included with the respective meningioma grade in the analysis. Secondary endpoints include median overall survival (mOS) and response rate. Results Fifty Patients (26 women; median age 54 years; range 23-81), 42 with progressive meningioma were treated: 10 G1M, 20 G2M, and 12 G3M. Prior treatments include surgical resection (41 patients), radiosurgery (24 patients), external beam radiotherapy (28 patients), and chemotherapy (14 patients). Median infusions administered were 16 (range, 2-68). Response was graded using the Macdonald's criteria. PFS-6, median PFS, and mOS were 87%, 22 months, 35 months for G1M; 77%, 23 months, 41 months for G2M; and 46%, 8 months, 12 months for G3M. Best radiographic responses include stable disease (G1M: 100%; G2M: 85%; G3M: 82%); partial response (G1M: 0%; G2M: 5%; G3M: 0%) and progressive disease (G1M: 0%; G2M: 10%; G3M:18%). The most common toxicities were hypertension (n = 19, 42.2%), proteinuria (n = 16, 35.6%), and fatigue (n = 14, 31.1%). Conclusion This study showed BEV is well tolerated and appears to be a promising systemic treatment option for patients with recurrent and refractory meningiomas.
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Affiliation(s)
- Priya Kumthekar
- The Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
| | - Sean Aaron Grimm
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Roxanne T Aleman
- Department of Internal Medicine, Advocate Christ Medical Center, Oak Lawn, IL, USA
| | - Marc C Chamberlain
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - David Schiff
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Patrick Y Wen
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard School of Medicine, Boston, MA, USA
| | | | - Demirkan Besim Gursel
- Northwestern University, Chicago, IL, USA
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - David A Reardon
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard School of Medicine, Boston, MA, USA
| | - Benjamin Purow
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Masha Kocherginski
- Department of Preventative Medicine, Feinberg College of Medicine at Northwestern University, Chicago, IL, USA
| | - Irene Helenowski
- Department of Preventative Medicine, Feinberg College of Medicine at Northwestern University, Chicago, IL, USA
| | - Jeffrey J Raizer
- The Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
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15
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Choudhary R, Elabbas A, Vyas A, Osborne D, Chigurupati HD, Abbas LF, Kampa P, M H F, Sarwar H, Alfonso M. Utilization of Cerebrospinal Fluid Proteome Analysis in the Diagnosis of Meningioma: A Systematic Review. Cureus 2021; 13:e20707. [PMID: 34966627 PMCID: PMC8710292 DOI: 10.7759/cureus.20707] [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] [Received: 11/05/2021] [Accepted: 12/26/2021] [Indexed: 12/17/2022] Open
Abstract
Meningiomas have been classified as the most commonly occurring primary brain tumors. Although the majority of meningiomas are benign and slow-progressing, the tumors that grow to a larger size are associated with various risks during surgical procedures. Early detection of meningiomas is crucial to the treatment as those detected early can be treated through non-invasive methods. Due to their benign nature, meningiomas contain homogeneous protein biomarkers that can be easily identified. Cerebrospinal fluid (CSF) has a high protein composition which can be used to diagnose various brain tumors. Because CSF comes into direct contact with the brain during its functioning, it is one of the factors that makes it an important source of different biomarkers. An analysis of biochemical changes occurring in the CSF can be useful in assessing the condition of the periventricular white matter and the parenchyma. In this review, PubMed, Medline, PubMed Central, and Google Scholar were used to identify studies discussing meningiomas regarding their assessment, types, diagnosis, and treatment, with more attention directed towards the application of CSF proteome analysis in diagnosis. Priority was given to studies published within the last 15 years. The following keywords were used in the literature search: “cerebrospinal fluid,” “meningiomas,” “brain tumors,” “primary brain tumors,” “protein biomarkers,” “proteome analysis,” and “diagnosis.” Subsequently, the 15 most relevant studies were selected for inclusion in the review. We excluded studies discussing different types of non-brain tumors as well as older articles. The selected studies also underwent a quality appraisal process using corresponding assessment tools. The selected articles were highly informative about meningiomas and the processes of diagnosis and treatment that are currently in use as well as those that are being developed or implemented. The use of CSF proteins in the diagnostic process is also discussed in this review. The studies also describe proteomics as a less invasive procedure that allows for the analysis of entire proteins and the projection of diagnostic images with higher resolutions that aid in the diagnosis.
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Affiliation(s)
- Rabia Choudhary
- Emergency Medicine, Internal Medicine, Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Adil Elabbas
- Radiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abhishek Vyas
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Darin Osborne
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Himaja Dutt Chigurupati
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Lawahiz F Abbas
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Prathima Kampa
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Farzana M H
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Hooria Sarwar
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Michael Alfonso
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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16
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Gündüz HB, Esen Aydın A, Karataş Okumuş SY, Çevik OM, Sofuoğlu ÖE, Uysal ML, Asiltürk M, Güneş M, Ovalıoğlu TC, Emel E. Retrospective Analysis and Comparison of 48 Intracranial Meningioma Cases As Two Groups According to Their Size. Cureus 2021; 13:e19709. [PMID: 34934575 PMCID: PMC8684358 DOI: 10.7759/cureus.19709] [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] [Accepted: 11/18/2021] [Indexed: 12/02/2022] Open
Abstract
Objective This study aims to examine the possible demographic, clinical, and surgical differences between giant and smaller meningiomas. Materials and Methods Forty-eight meningioma patients who were operated on in our clinic between 2016-2020 were included in our study. Fourteen meningiomas larger than 5 cm in diameter were defined as giant meningiomas and placed in group 1. Thirty-four remaining meningiomas, with sizes less than 5 cm, were placed in group 2. These patients were evaluated regarding age, sex, localization, symptoms and neurological findings, surgical results, histopathology, and postoperative results. Results The most common localization in group 1 was falcine-parasagittal, whereas in group 2 it was convexity. Simpson’s grade I resection rate in group 1 was 35.71%, while in group 2 this rate was 67.65%. In histopathological examination, transitional type meningiomas (35.71%) were the most common in group 1, whereas fibrous type meningiomas (32.35%) were seen the most in group 2. Group 1 Karnofsky Performance Scale score average was 75.71 preoperatively and 85.71 postoperatively. In group 2, the preoperative and postoperative average was 97.35 and 96.76, respectively. The comparative statistical analysis reflects that: A) Resection rates were significantly lower in the giant meningioma group. B) Similarly, Karnofsky Performance Scale scores were also lower than group 2. C) When statistical comparisons were made according to sex, age, localization, histopathological results, postoperative complications, and recurrence rates, no significant differences were observed. Conclusion The term “Giant Meningioma” is a type of distinction that is frequently made in the literature. However, the single major difference we see in our study was the surgical results. The general condition of patients before and after surgery may be more critical than others in giant meningiomas. Although surgical resection is the main form of treatment in giant meningiomas, the risks arising from the size of the tumor should be taken into account, and necessary plans should be made for a successful surgical intervention.
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Affiliation(s)
- Hasan Burak Gündüz
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Ayşegül Esen Aydın
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Seda Yağmur Karataş Okumuş
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Orhun Mete Çevik
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Özden Erhan Sofuoğlu
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Mustafa Levent Uysal
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Murad Asiltürk
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, istanbul, TUR
| | - Müslüm Güneş
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Talat Cem Ovalıoğlu
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
| | - Erhan Emel
- Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, TUR
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17
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Nakano T, Fujimoto K, Tomiyama A, Takahashi M, Achiha T, Arita H, Kawauchi D, Yasukawa M, Masutomi K, Kondo A, Narita Y, Maehara T, Ichimura K. Eribulin prolongs survival in an orthotopic xenograft mouse model of malignant meningioma. Cancer Sci 2021; 113:697-708. [PMID: 34839570 PMCID: PMC8819309 DOI: 10.1111/cas.15221] [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: 07/11/2021] [Revised: 11/04/2021] [Accepted: 11/22/2021] [Indexed: 11/27/2022] Open
Abstract
Meningioma is the most common intracranial tumor, with generally favorable patient prognosis. However, patients with malignant meningioma typically experience recurrence, undergo multiple surgical resections, and ultimately have a poor prognosis. Thus far, effective chemotherapy for malignant meningiomas has not been established. We recently reported the efficacy of eribulin (Halaven) for glioblastoma with a telomerase reverse transcriptase (TERT) promoter mutation. This study investigated the anti–tumor effect of eribulin against TERT promoter mutation‐harboring human malignant meningioma cell lines in vitro and in vivo. Two meningioma cell lines, IOMM‐Lee and HKBMM, were used in this study. The strong inhibition of cell proliferation by eribulin via cell cycle arrest was demonstrated through viability assay and flow cytometry. Apoptotic cell death in malignant meningioma cell lines was determined through vital dye assay and immunoblotting. Moreover, a wound healing assay revealed the suppression of tumor cell migration after eribulin exposure. Intraperitoneal administration of eribulin significantly prolonged the survival of orthotopic xenograft mouse models of both malignant meningioma cell lines implanted in the subdural space (P < .0001). Immunohistochemistry confirmed apoptosis in brain tumor tissue treated with eribulin. Overall, these results suggest that eribulin is a potential therapeutic agent for malignant meningiomas.
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Affiliation(s)
- Tomoyuki Nakano
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Neurosurgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Department of Brain Disease Translational Research, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kenji Fujimoto
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Life Sciences, Kumamoto University, Honjo, Kumamoto, Japan
| | - Arata Tomiyama
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Brain Disease Translational Research, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.,Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Masamichi Takahashi
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takamune Achiha
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hideyuki Arita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Daisuke Kawauchi
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chuo-ku, Chiba-shi, Chiba, Japan
| | - Mami Yasukawa
- Division of Cancer Stem Cell, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Kenkichi Masutomi
- Division of Cancer Stem Cell, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan.,Department of Brain Disease Translational Research, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
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18
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Maggio I, Franceschi E, Di Nunno V, Gatto L, Tosoni A, Angelini D, Bartolini S, Lodi R, Brandes AA. Discovering the Molecular Landscape of Meningioma: The Struggle to Find New Therapeutic Targets. Diagnostics (Basel) 2021; 11:1852. [PMID: 34679551 PMCID: PMC8534341 DOI: 10.3390/diagnostics11101852] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 02/06/2023] Open
Abstract
Meningiomas are the most common primary CNS tumors. They are usually benign but can present aggressive behavior in about 20% of cases. The genetic landscape of meningioma is characterized by the presence (in about 60% of cases) or absence of NF2 mutation. Low-grade meningiomas can also present other genetic alterations, particularly affecting SMO, TRAF7, KLF4 AKT1 and PI3KCA. In higher grade meningiomas, mutations of TERT promoter and deletion of CDKN2A/B seem to have a prognostic value. Furthermore, other genetic alterations have been identified, such as BAP1, DMD and PBRM1. Different subgroups of DNA methylation appear to be correlated with prognosis. In this review, we explored the genetic landscape of meningiomas and the possible therapeutic implications.
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Affiliation(s)
- Ilaria Maggio
- Medical Oncology Department, Azienda USL, Via Altura n. 3, 40139 Bologna, Italy; (I.M.); (V.D.N.); (L.G.)
| | - Enrico Franceschi
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Vincenzo Di Nunno
- Medical Oncology Department, Azienda USL, Via Altura n. 3, 40139 Bologna, Italy; (I.M.); (V.D.N.); (L.G.)
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Lidia Gatto
- Medical Oncology Department, Azienda USL, Via Altura n. 3, 40139 Bologna, Italy; (I.M.); (V.D.N.); (L.G.)
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Alicia Tosoni
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Daniele Angelini
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Stefania Bartolini
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; or
| | - Alba Ariela Brandes
- Nervous System Medical Oncology Department, IRCSS Istituto di Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (A.T.); (D.A.); (S.B.); (A.A.B.)
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Cucu AI, Turliuc MD, Costea CF, Dascălu CG, Dumitrescu GF, Sava A, Turliuc Ş, Scripcariu DV, Poeată I. Tumor recurrence in parasagittal and falcine atypical meningiomas invading the superior sagittal sinus. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:385-395. [PMID: 33544790 PMCID: PMC7864307 DOI: 10.47162/rjme.61.2.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Parasagittal and falcine meningiomas are still a challenge in terms of surgical resection. Although maximal safe resection is the main therapeutic approach, numerous postoperative complications can still occur depending on the locations of these tumors. Moreover, previous studies have reported that parasagittal meningiomas have a higher recurrence rate than meningiomas with other locations. Patients, Materials and Methods: We retrospectively reviewed 21 patients with parasagittal and falcine atypical meningiomas [World Health Organization (WHO) grade II], nine of whom had their superior sagittal sinus (SSS) invaded by the tumor. We reviewed the demographic information, operative notes, pathological reports, and clinical and imagistic follow-up reports of each patient over a 5-year time span. Results: All the patients were surgically treated, and the tumor removal was grade II according to Simpson’s grading system in 47.6% and grade III in 19% of the cases. The SSS was invaded in 42.9% of the patients. No immediate mortality or morbidity was revealed by our study. Tumor recurrence/progression documented on postoperative imaging amounted to 14.3% and 19%, 12 and 24 months after surgery, respectively. Furthermore, 36, 48 and 60 months after the surgery, the recurrence rate remained the same, namely in 9.5% of the cases. The recurrence was higher in patients with SSS invasion than in patients with no SSS invasion. The tumor recurrence was slightly more predominant in women, i.e., 6% higher than in the male group. Conclusions: In our group of patients with parasagittal and falcine meningiomas, we report a 47.6% Simpson II resection rate and 19% Simpson III resection rate associated with a very low complication rate and no immediately postoperative morbidity and mortality, compared to more aggressive techniques. The recurrence of parasagittal meningiomas predominated after grade III and IV Simpson resection and dural sinus invasion was a negative predictive factor for recurrence. Therefore, the surgery of parasagittal and falcine meningiomas is beneficial, both for tumor control, but also for improving neurological outcome. Aggressive meningioma resection should be balanced with the increased neurosurgical risk.
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Affiliation(s)
- Andrei Ionuţ Cucu
- Department of Ophthalmology, Department of Psychiatry, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Romania; ,
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20
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Okunlola AI, Ibijola AA, Babalola OF, Okunlola CK, Erinomo OO. Parasagittal cystic meningioma mimicking hemangioblastoma: A case report. Surg Neurol Int 2021; 12:368. [PMID: 34513135 PMCID: PMC8422409 DOI: 10.25259/sni_507_2021] [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] [Received: 05/21/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Cystic meningioma is a rare variety with similar histological profiles like the solid tumors. It has been documented in both supratentorial and infratentorial compartments presenting radiologically as a large cyst with mural nodule mimicking hemangioblastoma. Case Description: We managed a middle-aged woman who presented with recurrent seizures and brain MRI revealed left frontal cystic parasagittal tumor with mural nodule. She had left frontal awake craniotomy and gross total tumor excision. Histology confirmed meningothelial meningioma. Conclusion: Cystic meningioma is rare but should be high in differentials of cystic intracranial tumor with dural based nodules. Awake craniotomy is possible for the excision of parasagittal tumor most especially when it is frontal in location.
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Affiliation(s)
- Abiodun Idowu Okunlola
- Department of Surgery, Federal Teaching Hospital, Ido Ekiti/Afe Babalola University Ado Ekiti, Nigeria
| | | | - Olakunle Fatai Babalola
- Department of Surgery, Federal Teaching Hospital, Ido Ekiti/Afe Babalola University Ado Ekiti, Nigeria
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21
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Agapov MA, Donchenko KA, Kubyshkin VA, Kakotkin VV, Kasheev AA, Poltorako EN, Sigaleva TV, Bondar SV, Britikova MV. MULTIPLE PRIMARY SYNCHRONOUS NEOPLASMS OF THE SIGMOID COLON AND BREAST IN COMBINATION WITH SPINAL CORD MENINGIOMA. CLINICAL CASE. SURGICAL PRACTICE 2021. [DOI: 10.38181/2223-2427-2021-2-48-60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The incidence of multiple primary oncological diseases ranges from 2.4% to 17%. The main causes of primary multiple diseases include factors related to the patient's lifestyle, environmental and genetic factors, as well as factors related to the comprehensive treatment of previously identified malignant diseases.We demonstrate a clinical case of treatment of a patient with synchronous primary multiple cancer of the sigmoid colon and breast in combination with spinal cord meningioma. An interesting fact is the possible correlation between meningioma and breast cancer. Thus, the risk of meningioma in women who have had breast cancer and the risk of breast cancer in women with a history of meningioma is moderately increased (RR = 1.40-1.64 and 1.54, respectively). This two-way statistical association may be a consequence of common risk factors and a partial coincidence of gene-environmental interactions that determine carcinogenesis. Further research is needed to identify problems of prevention, screening, diagnosis, treatment and disease-free survival. It is important that patients diagnosed with cancer have information about possible late and long-term consequences of treatment and its symptoms, as well as possible signs of relapse and the appearance of secondary tumors. It is important that patients receiving treatment for malignant neoplasms follow the recommendations for cancer prevention and early detection, including smoking cessation, physical activity, nutrition and diet, a healthy weight and all standard cancer screening tests.
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Affiliation(s)
- M. A. Agapov
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU); Medical Research Educational Center, Lomonosov Moscow State University
| | - K. A. Donchenko
- Medical Research Educational Center, Lomonosov Moscow State University
| | - V. A. Kubyshkin
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)
| | - V. V. Kakotkin
- Medical Research Educational Center, Lomonosov Moscow State University
| | - A. A. Kasheev
- Medical Research Educational Center, Lomonosov Moscow State University
| | - E. N. Poltorako
- Medical Research Educational Center, Lomonosov Moscow State University
| | - T. V. Sigaleva
- Medical Research Educational Center, Lomonosov Moscow State University
| | - S. V. Bondar
- Medical Research Educational Center, Lomonosov Moscow State University
| | - M. V. Britikova
- Medical Research Educational Center, Lomonosov Moscow State University
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22
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Zhang L, Zhou Y, Wu B, Zhang S, Zhu K, Liu CH, Yu X, Alfano RR. Intraoperative detection of human meningioma using a handheld visible resonance Raman analyzer. Lasers Med Sci 2021; 37:1311-1319. [PMID: 34365551 DOI: 10.1007/s10103-021-03390-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
To report for the first time the preliminary results for the evaluation of a VRR-LRR™ analyzer based on visible resonance Raman technique to identify human meningioma grades and margins intraoperatively. Unprocessed primary and recurrent solid human meningeal tissues were collected from 33 patients and underwent Raman analysis during surgeries. A total of 1180 VRR spectra were acquired from fresh solid tissues using a VRR-LRR™ analyzer. A confocal HR Evolution (HORIBA, France SAS) Raman system with 532-nm excitation wavelength was also used to collect data for part of the ex vivo samples after they were thawed from - 80 °C for comparison. The preliminary analysis led to the following observations. (1) The intensity ratio of VRR peaks of protein to fatty acid (I2934/I2888) decreased with the increase of meningioma grade. (2) The ratio of VRR peaks of phosphorylated protein to amid I (I1588/I1639) decreased for the higher grade of meningioma. (3) Three RR vibration modes at 1378, 3174, and 3224 cm-1 which were related to the molecular vibrational bands of oxy-hemeprotein, amide B, and amide A protein significantly changed in peak intensities in the two types of meningioma tissues compared to normal tissue. (4) The changes in the intensities of VRR modes of carotenoids at 1156 and 1524 cm-1 were also found in the meningioma boundary. The VRR-LRR™ analyzer demonstrates a new approach for label-free, rapid, and objective identification of primary human meningioma in quasi-clinical settings. The accuracy for detecting meningioma tissues using support vector machines (SVMs) was over 70% based on Raman peaks of key biomolecules and up to 100% using principal component analysis (PCA).
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Affiliation(s)
- Liang Zhang
- Medical School of Nankai University, Tianjin, 300071, China.,Department of Neurosurgery, General Hospital, Beijing, 100853, China
| | - Yan Zhou
- Department of Neurosurgery, Air Force Medical Center, Beijing, 100142, China
| | - Binlin Wu
- Physics Department and CSCU Center for Nanotechnology, Southern Connecticut State University, New Haven, CT, 06515, USA
| | | | - Ke Zhu
- Institute of Physics, Chinese Academy of Sciences (CAS), PO Box 603, Beijing, 100190, China
| | - Cheng-Hui Liu
- Institute for Ultrafast Spectroscopy and Lasers, Department of Physics, The City College of the City University of New York, NY, 10031, New York, USA
| | - Xinguang Yu
- Medical School of Nankai University, Tianjin, 300071, China. .,Department of Neurosurgery, General Hospital, Beijing, 100853, China.
| | - Robert R Alfano
- Institute for Ultrafast Spectroscopy and Lasers, Department of Physics, The City College of the City University of New York, NY, 10031, New York, USA
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23
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Kulsum K, Suryadi T. Neuro-anesthetic Management of Craniotomy-surgery in Removal Tumor Multiple Meningioma Patients: A Case Report. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of following paper is to present the case anesthesia management of neuro-surgery in removal tumor multiple meningioma patients.
METHODS: The method of this study was a case report. It was reported that a patient aged 50 years complained of spasms of full body spasms since 10 minutes before admission to the hospital. Complaints were accompanied by eyes glaring upward, seizure duration 20 minutes, after convulsions of unconscious patients, patients with previous tumor history, 3 years ago, patients with postoperative meningioma tumor removal. Patient diagnosed with multiple meningioma who planned to undergo craniotomy surgery to remove the tumor.
MAIN FINDING: ASA 3 physical status with neurologic deficits. The patient is performed under general anesthesia with intubation. Induction performed by fentanyl, propofol and rocuronium. The operation lasted 3 hours. Postoperatively, the patient was admitted to the Intensive Care Unit for 2 days before moving into the room. Anesthetic treatment and regulation of physiological factors have a major impact on brain tissue. The anesthetist must have knowledge of the effects of drugs and other manipulations in order to achieve good surgical results.
RESULT: Anesthetic management for meningioma cases has several special matters that are important to carry out. The brain tissue is covered by the cranium bone. Because of the continuous relationship of blood flow and brain tissue volume, the risk of bleeding and edema is very high. Without a proper anesthetic approach, it can increase the risk of edema and cerebral hemorrhage due to surgical manipulation.
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24
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Tatman PD, Wroblewski TH, Fringuello AR, Scherer SR, Foreman WB, Damek DM, Lillehei K, Youssef AS, Jensen RL, Graner MW, Ormond DR. High-Throughput Mechanistic Screening of Epigenetic Compounds for the Potential Treatment of Meningiomas. J Clin Med 2021; 10:jcm10143150. [PMID: 34300316 PMCID: PMC8303324 DOI: 10.3390/jcm10143150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Meningiomas are the most common primary central nervous system tumors. 20–30% of these tumors are considered high-grade and associated with poor prognosis and high recurrence rates. Despite the high occurrence of meningiomas, there are no FDA-approved compounds for the treatment of these tumors. Methods: In this study, we screened patient-cultured meningiomas with an epigenetic compound library to identify targetable mechanisms for the potential treatment of these tumors. Meningioma cell cultures were generated directly from surgically resected patient tumors and were cultured on a neural matrix. Cells were treated with a library of compounds meant to target epigenetic functions. Results: Although each tumor displayed a unique compound sensitivity profile, Panobinostat, LAQ824, and HC toxin were broadly effective across most tumors. These three compounds are broad-spectrum Histone Deacetylase (HDAC) inhibitors which target class I, IIa, and IIb HDACs. Panobinostat was identified as the most broadly effective compound, capable of significantly decreasing the average cell viability of the sample cohort, regardless of tumor grade, recurrence, radiation, and patient gender. Conclusions: These findings strongly suggest an important role of HDACs in meningioma biology and as a targetable mechanism. Additional validation studies are necessary to confirm these promising findings, as well to identify an ideal HDAC inhibitor candidate to develop for clinical use.
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Affiliation(s)
- Philip D. Tatman
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Medical Scientist Training Program, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
- Department of Pharmacology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Tadeusz H. Wroblewski
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Anthony R. Fringuello
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - Samuel R. Scherer
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - William B. Foreman
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Denise M. Damek
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Department of Neurology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Kevin Lillehei
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - A. Samy Youssef
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
| | - Randy L. Jensen
- Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
| | - Michael W. Graner
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Correspondence: (M.W.G.); (D.R.O.)
| | - D. Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (P.D.T.); (T.H.W.); (A.R.F.); (S.R.S.); (W.B.F.); (D.M.D.); (K.L.); (A.S.Y.)
- Correspondence: (M.W.G.); (D.R.O.)
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25
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Lim-Fat MJ, Dietrich J. Myelopathies from Neoplasms. Semin Neurol 2021; 41:291-302. [PMID: 34030192 DOI: 10.1055/s-0041-1725948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Benign and malignant tumors can be an important cause of myelopathy. Patients may present with a wide range of neurologic symptoms including back and neck pain, weakness, sensory abnormalities, and bowel and bladder dysfunction. Management can be challenging depending on the location and underlying biology of the tumor. Neuroimaging of the spine is an important component of diagnostic evaluation and patient management both during initial evaluation and when monitoring after treatment. This article provides a systematic and practical review of neoplasms that can cause myelopathy. Unique imaging and biological features of distinct tumors are discussed, and their management strategies are reviewed.
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Affiliation(s)
- Mary Jane Lim-Fat
- Division of Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jorg Dietrich
- Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Boston, MA
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26
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Chukwueke UN, Wen PY. Medical management of meningiomas. HANDBOOK OF CLINICAL NEUROLOGY 2021; 170:291-302. [PMID: 32586501 DOI: 10.1016/b978-0-12-822198-3.00048-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Meningiomas are the most frequently occurring primary brain tumors in adults, representing almost one-third of all primary central nervous system tumors. Several factors have been suggested as an underlying cause in the development of meningiomas, such as ionizing radiation (therapeutic or other incidental exposure), hormonal factors, and genetic predisposition syndromes. Other established factors associated with meningiomas include age, female gender, and those from non-Hispanic Black backgrounds. Though the 2016 World Health Organization Classification of Brain Tumors largely preserves the existing grading scheme for organization of meningioma, there is increasing understanding of the molecular factors underlying the development of meningioma, some of which now form the basis for active clinical investigation. The mainstay of treatment has been the combination of radiation therapy and surgery, with a limited role for systemic therapy due to low efficacy, short duration of treatment response, and lack of uniform response criteria. Similar to other primary and metastatic brain tumors, immune-based therapies hold promise and are still under investigation.
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Affiliation(s)
- Ugonma N Chukwueke
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.
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27
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Tang TT, Konradi AW, Feng Y, Peng X, Ma M, Li J, Yu FX, Guan KL, Post L. Small Molecule Inhibitors of TEAD Auto-palmitoylation Selectively Inhibit Proliferation and Tumor Growth of NF2-deficient Mesothelioma. Mol Cancer Ther 2021; 20:986-998. [PMID: 33850002 DOI: 10.1158/1535-7163.mct-20-0717] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/22/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
Mutations in the neurofibromatosis type 2 (NF2) gene that limit or abrogate expression of functional Merlin are common in malignant mesothelioma. Merlin activates the Hippo pathway to suppress nuclear translocation of YAP and TAZ, the major effectors of the pathway that associate with the TEAD transcription factors in the nucleus and promote expression of genes involved in cell proliferation and survival. In this article, we describe the discovery of compounds that selectively inhibit YAP/TAZ-TEAD promoted gene transcription, block TEAD auto-palmitoylation, and disrupt interaction between YAP/TAZ and TEAD. Optimization led to potent analogs with excellent oral bioavailability and pharmacokinetics that selectively inhibit NF2-deficient mesothelioma cell proliferation in vitro and growth of subcutaneous tumor xenografts in vivo These highly potent and selective TEAD inhibitors provide a way to target the Hippo-YAP pathway, which thus far has been undruggable and is dysregulated frequently in malignant mesothelioma and in other YAP-driven cancers and diseases.
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Affiliation(s)
- Tracy T Tang
- Vivace Therapeutics, Inc., San Mateo, California.
| | | | - Ying Feng
- Vivace Therapeutics, Inc., San Mateo, California
| | - Xiao Peng
- Vivace Therapeutics, Inc., San Mateo, California
| | - Mingyue Ma
- Institute of Pediatrics, Children's Hospital of Fudan University, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College of Fudan University, Shanghai, China
| | - Jian Li
- Institute of Pediatrics, Children's Hospital of Fudan University, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College of Fudan University, Shanghai, China
| | - Fa-Xing Yu
- Institute of Pediatrics, Children's Hospital of Fudan University, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Medical College of Fudan University, Shanghai, China
| | - Kun-Liang Guan
- Department of Pharmacology and Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Leonard Post
- Vivace Therapeutics, Inc., San Mateo, California
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28
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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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29
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Meta R, Boldt HB, Kristensen BW, Sahm F, Sjursen W, Torp SH. The Prognostic Value of Methylation Signatures and NF2 Mutations in Atypical Meningiomas. Cancers (Basel) 2021; 13:cancers13061262. [PMID: 33809258 PMCID: PMC8001619 DOI: 10.3390/cancers13061262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 01/01/2023] Open
Abstract
Simple Summary The WHO 2016 classification of human meningiomas is debated due to the subjective evaluation of the histopathological diagnostics and grading. However, meningioma classification based on genome-wide DNA methylation profiling has become useful in classification of these tumors by being a better prognostic tool. The current pilot study was designed to test out genome-wide DNA methylation profiling on atypical meningiomas as these tumors have a highly variable risk of recurrence. Although we found that it had diagnostic value, further refinements on the methylation profile procedure are required. With this study we aim to motivate and impact researchers to continue to work and debate towards an improved meningioma classification including molecular and genetic biomarkers, which will benefit patients with such diagnoses. Abstract Background: Due to the solely subjective histopathological assessment, the WHO 2016 classification of human meningiomas is subject to interobserver variation. Consequently, the need for more reliable and objective markers are highly needed. The aim of this pilot study was to apply genome-wide DNA methylation analysis on a series of atypical meningiomas to evaluate the practical utility of this approach, examine whether prognostic subclasses are achieved and investigate whether there is an association between the methylation subclasses with poor prognosis and time to recurrence. NF1/2 mutation analyses were also performed to explore the prognostic value of such mutations in these atypical meningiomas. Methods: Twenty intracranial WHO grade II atypical meningiomas from adult patients were included. They consisted of 10 cases with recurrence (group I), and 10 cases without recurrence (group II). The formalin-fixed and paraffin-embedded tissues underwent standardized genome-wide DNA methylation analysis, and the profiles were matched with the reference library and tumor classifier from Heidelberg. NF1/2 somatic mutation analyses were performed using the CNSv1panel from Düsseldorf. Results: Eighteen out of 20 cases matched to the meningioma class using the common brain tumor classifier (v11b4). Four of these cases matched to a methylation subclass related to a prognostic subgroup based on a cut-off of 0.9. NF2 mutations were detected in 55% of cases across both groups, and the most prominent copy number alterations were chromosomal losses of 22q, 1p and 14q. No significant NF1 mutations were identified. Conclusions: Genome-wide DNA methylation profiling represents a useful tool in the diagnostics of meningiomas, however, methodological adjustments need to be addressed.
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Affiliation(s)
- Rahmina Meta
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (W.S.); (S.H.T.)
- Correspondence:
| | - Henning B. Boldt
- Department of Pathology, Odense University Hospital, 5000 Odense, Denmark; (H.B.B.); (B.W.K.)
- Research Unit of Pathology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Bjarne W. Kristensen
- Department of Pathology, Odense University Hospital, 5000 Odense, Denmark; (H.B.B.); (B.W.K.)
- Department of Pathology, The Bartholin Institute, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
- Biotech Research and Innovation Center (BRIC) and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
- Department of Oncology, Odense University Hospital, 5000 Odense, Denmark
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
- German Cancer Research Centre CCU Neuropathology (DKFZ), 69120 Heidelberg, Germany
| | - Wenche Sjursen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (W.S.); (S.H.T.)
- Department of Medical Genetics, St. Olavs Hospital, 7030 Trondheim, Norway
| | - Sverre H. Torp
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; (W.S.); (S.H.T.)
- Department of Pathology, St. Olavs Hospital, 7030 Trondheim, Norway
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Abstract
PURPOSE OF REVIEW Meningioma is a common intracranial neoplasm currently classified in 15 histologic subtypes across 3 grades of malignancy. First-choice therapy for meningioma is maximum safe resection for grade I tumors, and surgery plus optional and mandatory adjuvant radiotherapy for grade II and III, respectively, given the increased rate of recurrence even in the event of complete resection. The WHO 2016 histopathologic grading of meningioma has been questioned due to subjectivity and its controversial predictive power for recurrence. RECENT FINDINGS Novel DNA methylation profiling has simplified classification into six classes that seem to improve prognostic accuracy. We review five main topics of molecular biology research regarding tumorigenesis and natural history of meningioma from the clinician's perspective: the histopathologic diagnostic features and pitfalls of the current tumor classification; the molecular integrated diagnosis supported by identification of genetic alterations and DNA methylation profiling; the general landscape of the various signaling pathways involved in meningioma formation; the pathogenic theories of the peri-tumoral edema present in meningioma and its therapy implications; and a summarized review on the current treatments and plausible targeted therapies directed to meningioma. It seems likely that molecular assessment will be introduced within the next update of the WHO classification of meningiomas, acknowledging the promising value of DNA methylation profiling. This integrated diagnostic protocol will simplify tumor subtype categorization and provide improved accuracy in predicting recurrence and outcome. Although much effort is being done in identifying key gene mutations, and elucidating specific intracellular signaling pathways involved in meningioma tumorigenesis, effective targeted therapies for recurrent meningiomas are still lacking.
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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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Sun C, Dou Z, Wu J, Jiang B, Iranmanesh Y, Yu X, Li J, Zhou H, Zhong C, Peng Y, Zhuang J, Yu Q, Wu X, Yan F, Xie Q, Chen G. The Preferred Locations of Meningioma According to Different Biological Characteristics Based on Voxel-Wise Analysis. Front Oncol 2020; 10:1412. [PMID: 32974148 PMCID: PMC7472960 DOI: 10.3389/fonc.2020.01412] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Meningiomas presented preferred intracranial distribution, which may reflect potential biological natures. This study aimed to analyze the preferred locations of meningioma according to different biological characteristics. Method: A total of 1,107 patients pathologically diagnosed with meningiomas between January 2012 and December 2016 were retrospectively analyzed. Preoperative MRI were normalized, and lesions were semiautomatically segmented. The stereospecific frequency and p value heatmaps were constructed to compare two biological phenotypes using two-tailed Fisher's exact test. Age, sex, WHO grades, extent of resection (EOR), recurrence, and immunohistochemical markers including p53, Ki67, epithelial membrane antigen (EMA), progesterone receptor (PR), and CD34 were statistically analyzed. Recurrence-free survival (RFS) were analyzed by Kaplan-Meier method. Result: Of 1,107 cases, convexity (20.8%), parasagittal (16.1%), and falx (11.4%) were the most predominant loci of meningiomas. The p-value heatmap suggested lesion predominance in the left frontal and occipital convexity among older patients while in the left sphenoid wing, and right falx, parasellar/cavernous sinus, and middle fossa among younger patients. Lesions located at anterior fossa and frontal structures were more frequently seen in the male while left parietal falx and tentorial regions, and right cerebellopontine angle in the female. Grades II and III lesions presented predominance in the frontal structures compared with grade I ones. Meningiomas at the left parasagittal sinus and falx, tentorium, intraventricular regions, and skull-base structures were significantly to receive subtotal resection. Lesions with p53 positivity were statistically located at the left frontal regions and parasellar/cavernous sinus, higher Ki67 index at the left frontal and bilateral parietal convexity and right parasellar/cavernous sinus, EMA negativity at the right olfactory groove and left middle fossa, and CD34 positivity at the sellar regions and right sphenoid wing. Tumor recurrence rates for grades I, II, and III were 2.8, 7.9, and 53.8%, respectively. Inferior RFS, higher Ki67 index, grades II and III, and a larger preoperative volume were observed in older patients. Recurrent meningiomas were more frequently found at the occipital convexity, tentorium, sellar regions, parasagittal sinus, and left sphenoid wing. Conclusion: The preferred locations of meningioma could be observed according to different biological characteristics, which might be helpful for clinical decisions.
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Affiliation(s)
- Chongran Sun
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhangqi Dou
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiawei Wu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Biao Jiang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yasaman Iranmanesh
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaobo Yu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianru Li
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hang Zhou
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Zhong
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yucong Peng
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jianfeng Zhuang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qian Yu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinyan Wu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feng Yan
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qi Xie
- School of Life Science, Westlake University, Hangzhou, China
| | - Gao Chen
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Brastianos PK, Galanis E, Butowski N, Chan JW, Dunn IF, Goldbrunner R, Herold-Mende C, Ippen FM, Mawrin C, McDermott MW, Sloan A, Snyder J, Tabatabai G, Tatagiba M, Tonn JC, Wen PY, Aldape K, Nassiri F, Zadeh G, Jenkinson MD, Raleigh DR. Advances in multidisciplinary therapy for meningiomas. Neuro Oncol 2020; 21:i18-i31. [PMID: 30649489 DOI: 10.1093/neuonc/noy136] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Surgery has long been established as the first-line treatment for the majority of symptomatic and enlarging meningiomas, and evidence for its success is derived from retrospective case series. Despite surgical resection, a subset of meningiomas display aggressive behavior with early recurrences that are difficult to treat. The decision to radically resect meningiomas and involved structures is balanced against the risk for neurological injury in patients. Radiation therapy has largely been used as a complementary and safe therapeutic strategy in meningiomas with evidence primarily stemming from retrospective, single-institution reports. Two of the first cooperative group studies (RTOG 0539 and EORTC 22042) evaluating the outcomes of adjuvant radiation therapy in higher-risk meningiomas have shown promising preliminary results. Historically, systemic therapy has resulted in disappointing results in meningiomas. However, several clinical trials are under way evaluating the efficacy of chemotherapies, such as trabectedin, and novel molecular agents targeting Smoothened, AKT1, and focal adhesion kinase in patients with recurrent meningiomas.
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Affiliation(s)
- Priscilla K Brastianos
- Divisions of Hematology/Oncology & Neuro-Oncology, Departments of Medicine & Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Evanthia Galanis
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Jason W Chan
- Department of Radiation Oncology, University of California, San Francisco, California, USA
| | - Ian F Dunn
- Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Roland Goldbrunner
- Department of General Neurosurgery, University Hospital Cologne, Cologne, Germany
| | | | - Franziska M Ippen
- Divisions of Hematology/Oncology & Neuro-Oncology, Departments of Medicine & Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christian Mawrin
- Institute of Neuropathology, Otto-von-Guericke University, Magdeburg, Germany
| | - Michael W McDermott
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Andrew Sloan
- Department of Neurological Surgery, University Hospital-Case Medical Center, Cleveland, Ohio, USA
| | - James Snyder
- Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Ghazaleh Tabatabai
- Interdisciplinary Division of Neuro-Oncology, Hertie Institute for Clinical Brain Research & Centre for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - Joerg C Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University, Munich, Germany
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kenneth Aldape
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.,MacFeeters-Hamilton Center for Neuro-Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Farshad Nassiri
- MacFeeters-Hamilton Center for Neuro-Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, University Health Network, University of Toronto, Ontario, Canada.,MacFeeters-Hamilton Center for Neuro-Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Michael D Jenkinson
- Department of Neurosurgery & Institute of Translational Medicine, The Walton Centre NHS Foundation Trust & University of Liverpool, Lower Lane, Liverpool, Merseyside, UK
| | - David R Raleigh
- Department of Neurological Surgery, University of California, San Francisco, California, USA.,Department of Radiation Oncology, University of California, San Francisco, California, USA
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Kim E, Kim M, So K, Park YS, Woo CG, Hyun SH. Characterization and comparison of genomic profiles between primary cancer cell lines and parent atypical meningioma tumors. Cancer Cell Int 2020; 20:345. [PMID: 32742192 PMCID: PMC7388534 DOI: 10.1186/s12935-020-01438-x] [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] [Received: 05/06/2020] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background Meningiomas are the second most common primary tumors of the central nervous system. However, there is a paucity of data on meningioma biology due to the lack of suitable preclinical in vitro and in vivo models. In this study, we report the establishment and characterization of patient-derived, spontaneously immortalized cancer cell lines derived from World Health Organization (WHO) grade I and atypical WHO grade II meningiomas. Methods We evaluated high-resolution 3T MRI neuroimaging findings in meningioma patients which were followed by histological analysis. RT-qPCR and immunostaining analyses were performed to determine the expression levels of meningioma-related factors. Additionally, flow cytometry and sorting assays were conducted to investigate and isolate the CD133 and CD44 positive cells from primary atypical meningioma cells. Further, we compared the gene expression profiles of meningiomas and cell lines derived from them by performing whole-exome sequencing of the blood and tumor samples from the patients, and the primary cancer cell lines established from the meningioma tumor. Results Our results were consistent with earlier studies that reported mutations in NF2, SMO, and AKT1 genes in atypical meningiomas, and we also observed mutations in MYBL2, a gene that was recently discovered. Significantly, the genomic signature was consistent between the atypical meningioma cancer cell lines and the tumor and blood samples from the patient. Conclusion Our results lead us to conclude that established meningioma cell lines with a genomic signature identical to tumors might be a valuable tool for understanding meningioma tumor biology, and for screening therapeutic agents to treat recurrent meningiomas.
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Affiliation(s)
- Eunhye Kim
- Laboratory of Veterinary Embryology and Biotechnology (VETEMBIO), Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea.,Institute for Stem Cell & Regenerative Medicine (ISCRM), Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea
| | - Mirae Kim
- Laboratory of Veterinary Embryology and Biotechnology (VETEMBIO), Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea.,Institute for Stem Cell & Regenerative Medicine (ISCRM), Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea
| | - Kyungha So
- Laboratory of Veterinary Embryology and Biotechnology (VETEMBIO), Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea.,Institute for Stem Cell & Regenerative Medicine (ISCRM), Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea
| | - Young Seok Park
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University, College of Medicine, Cheongju, 28644 Republic of Korea
| | - Chang Gok Woo
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University, College of Medicine, Cheongju, 28644 Republic of Korea
| | - Sang-Hwan Hyun
- Laboratory of Veterinary Embryology and Biotechnology (VETEMBIO), Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea.,Institute for Stem Cell & Regenerative Medicine (ISCRM), Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644 Republic of Korea
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35
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Li L, Song M, Zhang C, Qian Z, Li Y, Li R, Li C, Yang Z, Zhou D. Hemangiopericytomas: Spatial Intracranial Location in a Voxel-Based Mapping Study. J Neuroimaging 2020; 30:370-377. [PMID: 32237258 DOI: 10.1111/jon.12701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE To investigate the preferred location of intracranial hemangiopericytomas (IHPCs) with voxel-based mapping and 3-dimensional reconstruction from MRI data. METHODS Gadolinium-enhanced tumors of 258 primary and single IHPCs were segmented semi-automatically, followed by manual checking and editing of boundaries. The lesions were registered to Montreal Neurological Institute standard anatomical space, and heat-map and 3-dimensional rendered frequency images were generated. All tumors were then superimposed on the Anatomical Automatic Labeling (AAL) template to further investigate the difference in the tumor location based on the voxel-wise frequency of occurrence with respect to laterality, sex, age, and pathologic grade. RESULTS The 3-dimensional rendered images show that the tumors commonly located in the posterior cranial cavity, surrounding the tentorium. The posterior third of the superior sagittal sinus and the confluence of sinuses were commonly affected. According to the analysis of tumor occurrence frequency in the AAL template, IHPCs were mainly observed in the limbic lobe, occipital lobe, and cerebellum. Tumors in younger patients preferentially located in the right occipital region (P = .027), whereas those with higher pathological grade more often located in the left parietal lobe (P = .034). CONCLUSIONS This is the first voxel-based study to explore the predilection site of IHPCs. Our study suggests that these tumors commonly affect the posterior cranial cavity, adjoining the tentorium and venous sinus. Further research is needed to investigate the possible factors underlying these topographic preferences.
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Affiliation(s)
- Lianwang Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Ming Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Chuanbao Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zenghui Qian
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yiming Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Runting Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Chao Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Zhengyi Yang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Dabiao Zhou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
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Baba A, McCradden MD, Rabski J, Cusimano MD. Determining the unmet needs of patients with intracranial meningioma-a qualitative assessment. Neurooncol Pract 2020; 7:228-238. [PMID: 32626591 PMCID: PMC7318855 DOI: 10.1093/nop/npz054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Meningiomas are the most common primary benign brain neoplasms, but despite their commonality, the supportive needs of this patient population have been overlooked. The aim of this study is to identify unmet needs of meningioma patients, caregivers, and health care providers. METHODS We adopted a patient-centered approach by using qualitative interviewing with patients diagnosed with a meningioma who have undergone treatment in the last 10 years since the date of their interview. Informal caregivers (family and/or friends) of the patient population and health care providers who are normally involved in the management and care of meningioma patients were also interviewed. Interview transcripts were subjected to thematic analysis. RESULTS Of the 50 participants interviewed, there were 30 patients, 12 caregivers, and 8 health care professionals. Thematic analysis revealed 4 overarching themes: (1) access to targeted postoperative care, (2) financial struggles for patients and their families, (3) lack of information specific to meningiomas and postsurgical management, and (4) lack of psychosocial support. CONCLUSION This study identified supportive needs specific to the meningioma patient population, which predominantly falls within the postoperative phase. The postoperative journey of this patient population could potentially extend to the rest of the patient's life, which necessitates resources and information directed to support postoperative recovery and management. The development of directly relevant supportive resources that support meningioma patients in their postoperative recovery is necessary to improve the health-related quality of life in this patient population.
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Affiliation(s)
- Ami Baba
- Injury Prevention Research Office, St. Michael’s Hospital, Division of Neurosurgery, Toronto, Ontario, Canada
| | - Melissa D McCradden
- Injury Prevention Research Office, St. Michael’s Hospital, Division of Neurosurgery, Toronto, Ontario, Canada
| | - Jessica Rabski
- Injury Prevention Research Office, St. Michael’s Hospital, Division of Neurosurgery, Toronto, Ontario, Canada
| | - Michael D Cusimano
- Injury Prevention Research Office, St. Michael’s Hospital, Division of Neurosurgery, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Surgery, St. Michael’s Hospital, University of Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
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37
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Patel KS, Kejriwal S, Sun MM, Thammachantha S, Duong C, Chan A, Cherian N, Romiyo P, Gordon LK, Yong W, Wadehra M, Yang I. Identification of epithelial membrane protein 2 (EMP2) as a molecular marker and correlate for angiogenesis in meningioma. J Neurooncol 2020; 147:15-24. [PMID: 31981014 DOI: 10.1007/s11060-020-03401-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Although intracranial meningiomas are the most common primary brain tumor in adults, treatment options are few and have traditionally been limited to surgical resection and radiotherapy. Additional targeted therapies and biomarkers are needed, especially as complete surgical resection is frequently not feasible in many patients. METHODS Non-pathologic brain tissue from 3 patients undergoing routine autopsies and tumor specimens from 16 patients requiring surgical resection for meningioma were collected. EMP2 protein expression was evaluated by immunohistochemistry and western blot analysis. EMP2 mRNA expression was also investigated using surgical specimens and validated by analysis of several independent NCBI GEO databases. RESULTS EMP2 mRNA expression levels were found to be higher in meningioma relative to non-pathologic meninges (P = 0.0013) and brain (P = 0.0011). Concordantly, strong EMP2 protein expression was demonstrated in 100% of meningioma specimens from all 16 patients, with no observable protein expression in normal brain tissue samples from 3 subjects (P < 0.001). EMP2 expression was confirmed by western blot analysis in five samples, with EMP2 protein intensity positively correlating with histologic staining score (R2 = 0.780; P = 0.047). No association was found between EMP2 mRNA or protein levels and WHO grade or markers of proliferation. However, EMP2 expression was positively associated with an angiomatous pattern on histologic evaluation (P = 0.0597), VEGF-A mRNA expression (P < 0.001), and clinical markers of tumor vascularity such as operative blood loss (P = 0.037). CONCLUSIONS EMP2 is not found in normal brain tissue, yet has shown consistently high mRNA and protein expression in meningiomas, and may serve as a useful molecular marker for these tumors.
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Affiliation(s)
- Kunal S Patel
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Sameer Kejriwal
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Michel M Sun
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - Samasuk Thammachantha
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Courtney Duong
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Ann Chan
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - Nina Cherian
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Prasanth Romiyo
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Lynn K Gordon
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - William Yong
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Madhuri Wadehra
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, CA, USA. .,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA. .,Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, UCLA Jonsson Comprehensive Cancer Center, 300 Stein Plaza, Ste. 562, 5th Floor Wasserman Bldg., Los Angeles, CA, 90095-6901, USA.
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38
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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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Barani S, Taghipour M, Ghaderi A. Positive association of Bx genotype, KIR2L5, KIR2DS5 and full-length KIR2DS4 with the risk of meningioma. Immunobiology 2019; 225:151900. [PMID: 31899050 DOI: 10.1016/j.imbio.2019.151900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/30/2019] [Accepted: 12/16/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND NK cells as a part of innate immune system, are controlled by a set of activating and inhibitory KIR receptors (aKIR, iKIR) which are implicated in tumor microenvironment immunity through a variety of activating and inhibitory immune signals. KIRs are multi gene family receptors that differ in the number and type of genes among individuals. In the current research we determined the KIRs genes and genotypes impact on predisposition to meningioma development in Iranians. METHODS Sequence-specific primers-polymerase chain reaction (SSP-PCR) was performed for genotyping of 16 KIRs in 159 meningioma cases and 362 age and sex matched healthy controls (CNs) at Shiraz Institute for Cancer Research. RESULTS Comparison of the KIR genotypes frequencies between cases and controls disclosed a highly significant increase in Bx genotype, CxTx subset and Cen AB and Tel AB in meningioma cases and a decrease in AA genotype, C4Tx subset and Cen AA, Tel AA, Tel BB in healthy controls. Among all 16 KIR genes, the carriers of KIR2DL5 and KIR2DS5 constituted a much greater proportion in meningioma than control group. Comparison of carrier frequencies of KIR2DS4 variants between case and controls revealed a higher frequency of KIR2DS4 full length (KIR2DS4fl) in meningioma cases and a lower frequency of KIR2DS4 deleted variant (KIR2DS4del) in controls. Furthermore, the simultaneous presence of 2DS5, 2DS4fl, CenAB, TelAB and absence of 2DS4del, CenAA, TelAA, TelBB, magnify the risk of developing meningioma substantially (OR ≈ 23). Altogether, 41 distinct KIR genotypes were characterized in 521 subjects. Among them, some individuals were characterized by seven peculiar genotypes that the linkage disequilibrium between KIR2DS2-KIR2DL2 and KIR2DL5-KIR2DS3-KIR2DS5 has not been detected. The carriers of certain genotypes with presence of as KIR2DL5 and absence of KIR2DS3, KIR2DS5 constituted a much higher proportion in meningioma than control group which increase the risk of meningioma up to 72 times. CONCLUSION This case- control study suggests carriers of Bx genotype, KIR2DL5, KIR2DS5, 2DS4fl, ≥ 4 iKIR, CxTx subset as well as Cen AB and Tel AB are associated with an increased risk of developing meningioma whereas carrying KIR2DS4del, AA, C4TX genotypes and Cen AA, Tel AA, Tel BB reduce the genetic predisposition for meningioma.
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Affiliation(s)
- Shaghik Barani
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Taghipour
- Neurosurgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Jamilson Araújo Pereira B, Nogueira de Almeida A, Henrique Pires de Aguiar P, Silva Paiva W, Jacobsen Teixeira M, Kazue Nagahashi Marie S. Comprehensive analysis of meningioma in the first two decades of life: A systematic review. Neurochirurgie 2019; 66:36-40. [PMID: 31809786 DOI: 10.1016/j.neuchi.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the relationship between meningioma histological subtype and tumor site in under-20 year-olds. METHODS A review of the literature on meningioma during the first 2 decades of life was carried out through a Medline search up to February 2019. To evaluate the adult population, a cross-sectional study was conducted on patients operated on between 2000 and 2014 in a single institution. Exclusion criteria comprised: series reports and papers that lacked detailed description of clinical findings, neuroimaging confirmation of tumor location, and/or at least 5 years' follow-up. RESULTS One hundred and seven manuscripts were included, for 365 under-20 year-old patients: 200 male, and 164 female. Histopathology found 197 cases (53.9%) of WHO grade I meningioma, with predominance of meningothelial (41.1%) and transitional (30.9%) subtypes; 123 (33.7%) grade II, and 45 (12.3%) grade III. For 65 (18.25%) of the 356 cases, recurrence was documented, with only 24 deaths (6.7%). CONCLUSION Meningioma in this population presented 2 differences compared to the adult population: male predominance, and high incidence of atypical meningioma. Surgery was the primary treatment. Adjuvant radiotherapy is controversial in the literature.
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Affiliation(s)
- B Jamilson Araújo Pereira
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil; Departmento de Neurologia, Laboratório de biologia cellular e molecular LIM15, Escola de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - A Nogueira de Almeida
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil; Divisão de Neurocirurgia Funcional IPQ. Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | | | - W Silva Paiva
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | - M Jacobsen Teixeira
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
| | - S Kazue Nagahashi Marie
- Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, SP, Brazil
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Bukovac A, Kafka A, Hrašćan R, Vladušić T, Pećina-Šlaus N. Nucleotide variations of TP53 exon 4 found in intracranial meningioma and in silico prediction of their significance. Mol Clin Oncol 2019; 11:563-572. [PMID: 31692929 PMCID: PMC6826266 DOI: 10.3892/mco.2019.1936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/20/2019] [Indexed: 01/28/2023] Open
Abstract
The aim of the present study was to identify TP53 exon 4 mutations in patients with meningioma and to investigate their potential association with specific tumor pathology. Nucleotide alterations were investigated in 48 meningiomas via the direct sequencing of TP53 exon 4 in patient tumor and blood samples using the DNA Sanger method with the BigDyeTerminator v3.1 Cycle Sequencing kit and Applied Biosystems 3730XL apparatus. The results revealed that TP53 exon 4 was frequently altered in meningioma, occurring in 60.4% of the patients investigated. A total of 18 different alterations were detected in the meningioma samples assessed in the current study. The majority of these appeared more than once and some were repeatedly identified in several patients. Changes at codons 72 (c.215G>C) and 62 (c.186delA) were highly prevalent, occurring in 44.8% of patients. Other changes detected via frequency analysis included: Five substitutions on codon 105 (c.315C>T); four insertions on codon 70 (c.209_210insG); three insertions on codon 64 (c.190C>G), 82 (245C>T; 245delC; 243_244insA) and 104 (c.312G>A); and two insertions on codons 108 (c.322G>C), 71 (c.213C>A), 73 (c.217G>A), 91 (c.271T>C) and 100 (c.300G>T). Codons 68 (c.202_203insT), 77 (c.229C>T), 88 (c.263C>G) and 92 (c.276C>A) were altered once. Alterations on codons 82, 91, 108, 104, 105, 70 and 92 were characterized as possibly damaging by PolyPhen-2 and Mutation Taster2 tools. The current study also demonstrated that nucleotide alterations were significantly associated with the loss of p53 expression (P=0.04) and female patients (P=0.049), particularly codon 72. The results present novel data on the mutational spectrum of TP53 in meningeal brain tumors.
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Affiliation(s)
- Anja Bukovac
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.,Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Anja Kafka
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.,Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Reno Hrašćan
- Department of Biochemical Engineering, Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Vladušić
- Department of Biochemical Engineering, Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia
| | - Nives Pećina-Šlaus
- Laboratory of Neurooncology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.,Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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42
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AlSahlawi A, Aljelaify R, Magrashi A, AlSaeed M, Almutairi A, Alqubaishi F, Alturkistani A, AlObaid A, Abouelhoda M, AlMubarak L, AlTassan N, Abedalthagafi M. New insights into the genomic landscape of meningiomas identified FGFR3 in a subset of patients with favorable prognoses. Oncotarget 2019; 10:5549-5559. [PMID: 31565188 PMCID: PMC6756861 DOI: 10.18632/oncotarget.27178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022] Open
Abstract
Background: With a prevalence of 170 000 adults in the US alone, meningiomas are the most common primary intracranial tumors. The management of skull base meningiomas is challenging due to their complexity and proximity to crucial nearby structures. The identification of oncogenic mutations has provided further insights into the tumorigenesis of meningioma and the possibility of targeted therapy.
This study aimed to further investigate the association of mutational profiles with anatomical distribution, histological subtype, WHO grade, and recurrence in patients with meningioma. Methods: Tissue samples were collected from 71 patients diagnosed with meningioma from 2008 to 2016. A total of 51 cases were skull based. Samples were subjected to targeted sequencing using a next generation customized cancer gene panel (n = 66 genes analyzed).
Results: We detected genomic alterations (GAs) in 68 tumors, averaging 1.56 ± 1.07 genomic alterations (GAs) per sample. NF2 was the most frequently altered gene (36/71 cases). Interestingly, we identified a number of mutations in non-NF2 genes, including a hotspot TERTp c.−124: G > A mutation that may be related to poor prognosis and FGFR3 mutations that may represent biomarkers of a favorable prognosis as reported in other cancers.
Conclusions: We demonstrate that comprehensive genomic profiling in our population can reveal a potential new prognostic biomarkers of skull base meningioma. These mutations can enhance diagnostic accuracy and clinical decision-making. Among our findings were the identification of a TERTp mutation and the first report of FGFR3 mutations that may represent biomarkers for the identification of skull base meningioma patients with a favorable prognosis.
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Affiliation(s)
- Aysha AlSahlawi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Montreal Neurological Institute, Montreal, Canada.,Neurosurgery Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Rasha Aljelaify
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Amna Magrashi
- Genetics Department, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mariam AlSaeed
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Amal Almutairi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Fatimah Alqubaishi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | | | - Abdullah AlObaid
- Neurosurgery Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohamed Abouelhoda
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia.,Genetics Department, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Latifa AlMubarak
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Nada AlTassan
- Saudi Human Genome Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia.,Genetics Department, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
| | - Malak Abedalthagafi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.,Genetics Department, King Faisal Specialists Hospital and Research Center, Riyadh, Saudi Arabia
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43
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Kerr K, Qualmann K, Esquenazi Y, Hagan J, Kim DH. Familial Syndromes Involving Meningiomas Provide Mechanistic Insight Into Sporadic Disease. Neurosurgery 2019; 83:1107-1118. [PMID: 29660026 PMCID: PMC6235681 DOI: 10.1093/neuros/nyy121] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/12/2018] [Indexed: 12/20/2022] Open
Abstract
Currently, there is an incomplete understanding of the molecular pathogenesis of meningiomas, the most common primary brain tumor. Several familial syndromes are characterized by increased meningioma risk, and the genetics of these syndromes provides mechanistic insight into sporadic disease. The best defined of these syndromes is neurofibromatosis type 2, which is caused by a mutation in the NF2 gene and has a meningioma incidence of approximately 50%. This finding led to the subsequent discovery that NF2 loss-of-function occurs in up to 60% of sporadic tumors. Other important familial diseases with increased meningioma risk include nevoid basal cell carcinoma syndrome, multiple endocrine neoplasia 1 (MEN1), Cowden syndrome, Werner syndrome, BAP1 tumor predisposition syndrome, Rubinstein-Taybi syndrome, and familial meningiomatosis caused by germline mutations in the SMARCB1 and SMARCE1 genes. For each of these syndromes, the diagnostic criteria, incidence in the population, and frequency of meningioma are presented to review the relevant clinical information for these conditions. The genetic mutations, molecular pathway derangements, and relationship to sporadic disease for each syndrome are described in detail to identify targets for further investigation. Familial syndromes characterized by meningiomas often affect genes and pathways that are also implicated in a subset of sporadic cases, suggesting key molecular targets for therapeutic intervention. Further studies are needed to resolve the functional relevance of specific genes whose significance in sporadic disease remains to be elucidated.
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Affiliation(s)
- Keith Kerr
- Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - Krista Qualmann
- Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - Yoshua Esquenazi
- Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - John Hagan
- Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - Dong H Kim
- Vivian L. Smith Department of Neurosurgery, University of Texas Health Science Center at Houston, Texas
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44
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Loewenstern J, Shuman W, Rutland JW, Kessler RA, Kohli KM, Umphlett M, Pain M, Bederson J, Fowkes M, Shrivastava RK. Preoperative and Histological Predictors of Recurrence and Survival in Atypical Meningioma After Initial Gross Total Resection. World Neurosurg 2019; 128:e148-e156. [DOI: 10.1016/j.wneu.2019.04.069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
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45
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Nigim F, Kiyokawa J, Gurtner A, Kawamura Y, Hua L, Kasper EM, Brastianos PK, Cahill DP, Rabkin SD, Martuza RL, Carbonell WS, Wakimoto H. A Monoclonal Antibody Against β1 Integrin Inhibits Proliferation and Increases Survival in an Orthotopic Model of High-Grade Meningioma. Target Oncol 2019; 14:479-489. [DOI: 10.1007/s11523-019-00654-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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46
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Kim H, Park KJ, Ryu BK, Park DH, Kong DS, Chong K, Chae YS, Chung YG, Park SI, Kang SH. Forkhead box M1 (FOXM1) transcription factor is a key oncogenic driver of aggressive human meningioma progression. Neuropathol Appl Neurobiol 2019; 46:125-141. [PMID: 31179553 DOI: 10.1111/nan.12571] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 06/04/2019] [Indexed: 12/11/2022]
Abstract
AIMS Aggressive meningioma remains incurable with neither chemo- nor targeted therapies proven effective, largely due to unidentified genetic alterations and/or aberrant oncogenic pathways driving the disease progression. In this study, we examined the expression and function of Forkhead box M1 (FOXM1) transcription factor during meningioma progression. METHODS Human meningioma samples (n = 101) were collected, followed by Western blotting, quantitative PCR, immunohistochemical and progression-free survival (PFS) analyses. For in vitro assays, FOXM1 was overexpressed or knocked-down in benign (SF4433 and SF4068) or malignant (SF3061 and IOMM-Lee) human meningioma cell lines respectively. For in vivo studies, siomycin A (a FOXM1 inhibitor)-pretreated or control IOMM-Lee cells were implanted subcutaneously in nude mice. RESULTS FOXM1 expression was increased in higher grades of meningioma and correlated with the mitotic index in the tumour tissue. Moreover, FOXM1 was increased in recurrent meningioma compared with the matched primary lesions. The patients who had higher FOXM1 expression had shorter PFS. In the subsequent in vitro assays, knockdown of FOXM1 in malignant meningioma cell lines resulted in decreased tumour cell proliferation, angiogenesis and invasion, potentially via regulation of β-catenin, cyclin D1, p21, interleukin-8, vascular endothelial growth factor-A, PLAU, and epithelial-to-mesenchymal transition-related genes, whereas overexpression of FOXM1 in benign meningioma cell lines had the opposite effects. Last, suppression of FOXM1 using a pharmacological inhibitor, siomycin A, decreased tumour growth in an in vivo mouse model. CONCLUSIONS Our data demonstrate that FOXM1 is a key transcription factor regulating oncogenic signalling pathways in meningioma progression, and a promising therapeutic target for aggressive meningioma.
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Affiliation(s)
- H Kim
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - K-J Park
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - B-K Ryu
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - D-H Park
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - D-S Kong
- Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Chong
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - Y-S Chae
- Department of Pathology, Korea University College of Medicine, Seoul, Korea
| | - Y-G Chung
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
| | - S I Park
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, Korea.,The BK21 Plus Program, Korea University College of Medicine, Seoul, Korea.,Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.,Vanderbilt Centre for Bone Biology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - S-H Kang
- Department of Neurosurgery, Korea University Anam Hospital, Seoul, Korea
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Supartoto A, Mahayana IT, Heriyanto DS, Sasongko MB, Respatika HD, Sakti DH, Nurlaila PS, Kusnanto H, Pawiroranu S, Haryana SM. Neurofibromatosis type 2 gene mutation and progesterone receptor messenger RNA expression in the pathogenesis of sporadic orbitocranial meningioma. Int J Ophthalmol 2019; 12:571-576. [PMID: 31024808 DOI: 10.18240/ijo.2019.04.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/03/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate neurofibromatosis type 2 (NF2) gene mutation at mRNA levels in sporadic orbitocranial meningioma and its association with progesterone receptor (PR) mRNA expression. METHODS This was a case-control study. Thirty-four sporadic meningioma patients with no familial NF2-related meningioma history were recruited. They were interviewed for their obstetric, gynecologic, and contraception history. PR investigation was performed with real-time polymerase chain reaction (PCR). NF2 mutation was investigated using Qbiomarker Somatic Mutation PCR Assay at NF2 mRNA level after its cDNA extraction (four mRNA mutation cytoband coordinates for nucleotide change: c.634C>T/p.Q212, c.655G>A/p.V219M, c.784C>T/p.R262 and c.1228C>T/p. Q410). RESULTS After mutation analysis at mRNA level, NF2 gene mutation was found in 35.29% patients. Non-mutation group was strongly associated with exogenous hormonal exposure (non-mutation vs mutation: 95.5% vs 83.3%, P<0.001). PR mRNA was found significantly lower in non-mutation group (P=0.033) which presumed as long term exogenous progesterone exposure. However, mutation group was associated with higher rate of progression to grade II (mutation vs non-mutation, 18.2% vs 5%, P<0.001) and was associated more in fibrous and anaplastic tumor tissue. CONCLUSION NF2 mutation-meningioma is associated with higher grade of meningioma. Non NF2 mutation-meningioma is strongly associated with exogenous progesterone exposure and lower PR expression.
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Affiliation(s)
- Agus Supartoto
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Indra Tri Mahayana
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Didik Setyo Heriyanto
- Department of Pathological Anatomy, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Muhammad Bayu Sasongko
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Henricus Datu Respatika
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Dhimas Hari Sakti
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Prima Sugesty Nurlaila
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Hari Kusnanto
- Department of Biostatistics Epidemiology and Population Health, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Suhardjo Pawiroranu
- Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia
| | - Sofia Mubarika Haryana
- Department of Histology and Cell Biology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
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48
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da Silva CE, de Freitas PEP. Surgical Removal of Skull Base Meningiomas in Symptomatic Elderly Patients. World Neurosurg 2018; 120:e1149-e1155. [DOI: 10.1016/j.wneu.2018.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 11/24/2022]
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49
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Buerki RA, Horbinski CM, Kruser T, Horowitz PM, James CD, Lukas RV. An overview of meningiomas. Future Oncol 2018; 14:2161-2177. [PMID: 30084265 PMCID: PMC6123887 DOI: 10.2217/fon-2018-0006] [Citation(s) in RCA: 250] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023] Open
Abstract
Meningiomas are the most common primary intracranial tumor. Important advances are occurring in meningioma research. These are expected to accelerate, potentially leading to impactful changes on the management of meningiomas in the near and medium term. This review will cover the histo- and molecular pathology of meningiomas, including recent 2016 updates to the WHO classification of CNS tumors. We will discuss clinical and radiographic presentation and therapeutic management. Surgery and radiotherapy, the two longstanding primary therapeutic modalities, will be discussed at length. In addition, data from prior and ongoing investigations of other treatment modalities, including systemic and targeted therapies, will be covered. This review will quickly update the reader on the contemporary management and future directions in meningiomas. [Formula: see text].
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Affiliation(s)
- Robin A Buerki
- Department of Neurological Surgery, University of California San Francisco, 400 Parnassus Ave., San Francisco, CA 94143, USA
| | - Craig M Horbinski
- Department of Pathology, Northwestern University, IL 60611, USA
- Lou & Jean Malnati Brain Tumor Institute at the Lurie Comprehensive Cancer Center, Northwestern University, IL 60611, USA
| | - Timothy Kruser
- Lou & Jean Malnati Brain Tumor Institute at the Lurie Comprehensive Cancer Center, Northwestern University, IL 60611, USA
- Department of Radiation Oncology, Northwestern University, IL 60611, USA
| | - Peleg M Horowitz
- Section of Neurosurgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Charles David James
- Lou & Jean Malnati Brain Tumor Institute at the Lurie Comprehensive Cancer Center, Northwestern University, IL 60611, USA
- Department of Neurosurgery, Northwestern University, IL 60611, USA
| | - Rimas V Lukas
- Lou & Jean Malnati Brain Tumor Institute at the Lurie Comprehensive Cancer Center, Northwestern University, IL 60611, USA
- Department of Neurology, Northwestern University, 710 North Lake Shore Drive, Abbott Hall 1114, Chicago, IL 60611, USA
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50
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Sharma P, Katiyar V, Sharma R, Gurjar HK, Krishnan S. Letter: Role of Tyrosine Kinase Inhibitors in Recurrent Meningiomas: Controversies and Promises. Neurosurgery 2018; 82:E181-E183. [DOI: 10.1093/neuros/nyy055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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