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Neurosurgical Review Aug 2022Treatment of meningiomas refractory to surgery and irradiation is challenging and effective chemotherapies are still lacking. Recently, in vitro analyses revealed...
Treatment of meningiomas refractory to surgery and irradiation is challenging and effective chemotherapies are still lacking. Recently, in vitro analyses revealed decitabine (DCT, 5-aza-2'-deoxycytidine) to be effective in high-grade meningiomas and, moreover, to induce hypomethylation of distinct oncogenes only sparsely described in meningiomas in vivo yet.Expression of the corresponding onco- and tumor suppressor genes TRIM58, FAM84B, ELOVL2, MAL2, LMO3, and DIO3 were analyzed and scored by immunohistochemical staining and RT-PCR in samples of 111 meningioma patients. Correlations with clinical and histological variables and prognosis were analyzed in uni- and multivariate analyses.All analyzed oncogenes were highly expressed in meningiomas. Expression scores of TRIM58 tended to be higher in benign than in high-grade tumors 20 vs 16 (p = .002) and all 9 samples lacking TRIM58 expression displayed WHO grade II/III histology. In contrast, median expression scores for both FAM84B (6 vs 4, p ≤ .001) and ELOVL2 (9 vs 6, p < .001) were increased in high-grade as compared to benign meningiomas. DIO3 expression was distinctly higher in all analyzed samples as compared to the reference decitabine-resistant Ben-Men 1 cell line. Increased ELOVL2 expression (score ≥ 8) correlated with tumor relapse in both uni- (HR: 2.42, 95%CI 1.18-4.94; p = .015) and multivariate (HR: 2.09, 95%CI 1.01-4.44; p = .046) analyses.All oncogenes involved in DCT efficacy in vitro are also widely expressed in vivo, and expression is partially associated with histology and prognosis. These results strongly encourage further analyses of DCT efficiency in meningiomas in vitro and in situ.
Topics: Decitabine; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Oncogenes; Prognosis
PubMed: 35445910
DOI: 10.1007/s10143-022-01789-1 -
International Journal of Molecular... Apr 2024Meningiomas are tumors of the central nervous system that vary in their presentation, ranging from benign and slow-growing to highly aggressive. The standard method for... (Review)
Review
Meningiomas are tumors of the central nervous system that vary in their presentation, ranging from benign and slow-growing to highly aggressive. The standard method for diagnosing and classifying meningiomas involves invasive surgery and can fail to provide accurate prognostic information. Liquid biopsy methods, which exploit circulating tumor biomarkers such as DNA, extracellular vesicles, micro-RNA, proteins, and more, offer a non-invasive and dynamic approach for tumor classification, prognostication, and evaluating treatment response. Currently, a clinically approved liquid biopsy test for meningiomas does not exist. This review provides a discussion of current research and the challenges of implementing liquid biopsy techniques for advancing meningioma patient care.
Topics: Humans; Biomarkers, Tumor; Extracellular Vesicles; Liquid Biopsy; Meningeal Neoplasms; Meningioma; Prognosis
PubMed: 38673779
DOI: 10.3390/ijms25084195 -
Chinese Clinical Oncology Jul 2017Meningiomas account for approximately one-third of primary central nervous system tumors with a subset that are aggressive and carry significant morbidity and mortality.... (Review)
Review
Meningiomas account for approximately one-third of primary central nervous system tumors with a subset that are aggressive and carry significant morbidity and mortality. Treatment of these high-grade meningiomas, classified by the World Health Organization as grade II (atypical) and grade III (anaplastic) meningiomas, typically includes the combination of surgery and radiotherapy. However, current data guiding the timing, dosage, and modality of radiation treatment (RT) has been limited to case series and retrospective studies. Nevertheless, most studies support that radiation therapy reduces recurrence risk and improves overall survival (OS) for patients with high-grade meningiomas. In this review, we examine the evidence for radiation therapy in the management of patients with atypical and anaplastic meningiomas and discuss current ongoing prospective trials that will further elucidate the optimal role of radiotherapy in the treatment of these aggressive tumors.
Topics: Humans; Meningeal Neoplasms; Meningioma; Neoplasm Grading; Prospective Studies; Radiosurgery; Retrospective Studies
PubMed: 28758409
DOI: 10.21037/cco.2017.06.09 -
Neuro-oncology Jan 2022
Topics: Benchmarking; Boron Neutron Capture Therapy; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local
PubMed: 34508643
DOI: 10.1093/neuonc/noab217 -
Neurology India 2018The 2016 central nervous system (CNS) World Health Organisation (WHO) Update has merged the entities of meningeal solitary fibrous tumor (SFT) and hemangiopericytoma... (Review)
Review
BACKGROUND
The 2016 central nervous system (CNS) World Health Organisation (WHO) Update has merged the entities of meningeal solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) into a single entity based on the presence of the nerve growth factor 1A (NGFI-A) binding protein 2 (NAB2)- signal transducer and activator of transcription 6 (STAT6) gene fusion in these tumors. Immunohistochemical (IHC) staining with STAT6 results in a strong nuclear positivity confirming the diagnosis. Meningeal SFT/HPCs are currently histologically graded according to a three-tiered system. Grade I (SFT phenotype) is benign, whereas grades II and III (HPC phenotype) are malignant and require radiotherapy in addition to gross total resection.
OBJECTIVES
The objectives were to review the cases diagnosed as meningeal SFT or HPC between 2010 and 2017 and classify them into SFT (grade I) or HPC (grades II and III) phenotypes; to confirm the diagnosis by performing STAT6 immunohistochemistry; and to observe and record the histological features in detail and correlate the tumor grades with their behavior. The published literature on the subject was also reviewed.
MATERIALS AND METHODS
A total of 21 cases diagnosed between 2010 and 2017 as meningeal SFT or HPC were included in the study. All cases were reviewed by the authors and were categorized and graded according to histologic phenotype and mitotic count. STAT6 immunohistochemistry was performed in all the cases. The epidemiological data and histologic findings in each case were recorded in detail. The follow-up of patients was obtained.
RESULTS
Fifteen patients were males and six were females. The mean age was 43.5 years. The mean tumor size was 6.8 cm. The tumor specimens in 20 out of 21 cases corresponded to the HPC phenotype, of which 6 were in grade II while 14 were in grade III. Thus, over 95% cases had malignant lesions. The tumor in all the 21 cases recruited for the study showed immunohistochemical positivity for SAT6, while CD34 was positive in all the 18 tumor in which it was performed. The follow-up was available in 14 of the patients. Recurrence occurred in six patients who had either a grade II or a grade III tumor and three patients died (including one patient with a grade III tumor. This patient died a month after initial resection although there was no evidence of recurrence). Radiotherapy was given to only 4 out of 14 patients in whom follow-up was available.
CONCLUSION
These rare tumors need to be accurately diagnosed and optimally treated (gross total resection and radiotherapy) to improve the prognosis.
Topics: Adolescent; Adult; Aged; Female; Hemangiopericytoma; Humans; Immunohistochemistry; Male; Meningeal Neoplasms; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local; Prognosis; STAT6 Transcription Factor; Solitary Fibrous Tumors; Young Adult
PubMed: 30233017
DOI: 10.4103/0028-3886.241365 -
Asian Journal of Surgery Oct 2023
Topics: Humans; Meningioma; Radiosurgery; Treatment Outcome; Retrospective Studies; Meningeal Neoplasms
PubMed: 37244825
DOI: 10.1016/j.asjsur.2023.04.135 -
EBioMedicine Aug 2023The incidence of newly diagnosed meningiomas, particularly those diagnosed incidentally, is continually increasing. The indication for treatment is empirical because,...
BACKGROUND
The incidence of newly diagnosed meningiomas, particularly those diagnosed incidentally, is continually increasing. The indication for treatment is empirical because, despite numerous studies, the natural history of these tumours remains difficult to describe and predict.
METHODS
This retrospective single-centre study included 294 consecutive patients with 333 meningiomas who underwent three or more brain imaging scans. Linear, exponential, power, and Gompertz models were constructed to derive volume-time curves, by using a mixed-effect approach. The most accurate model was used to analyse tumour growth and predictors of rapid growth.
FINDINGS
The Gompertz model provided the best results. Hierarchical clustering at the time of diagnosis and at the end of follow-up revealed at least three distinct groups, which can be described as pseudoexponential, linear, and slowing growth with respect to their parameters. Younger patients and smaller tumours were more frequent in the pseudo-exponential clusters. We found that the more "aggressive" the cluster, the higher the proportion of patients with grade II meningiomas and who have had a cranial radiotherapy. Over a mean observation period of 56.5 months, 21% of the tumours moved to a cluster with a lower growth rate, consistent with the Gompertz's law.
INTERPRETATION
Meningiomas exhibit multiple growth phases, as described by the Gompertz model. The management of meningiomas should be discussed according to the growth phase, comorbidities, tumour location, size, and growth rate. Further research is needed to evaluate the associations between radiomics features and the growth phases of meningiomas.
FUNDING
No funding.
Topics: Humans; Meningioma; Meningeal Neoplasms; Retrospective Studies; Neuroimaging
PubMed: 37413890
DOI: 10.1016/j.ebiom.2023.104697 -
Tidsskrift For Den Norske Laegeforening... Jun 2019
Topics: Aged; Female; Fluorescein Angiography; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Optic Nerve Diseases; Papilledema
PubMed: 31238653
DOI: 10.4045/tidsskr.18.0719 -
International Journal of Molecular... Feb 2022Meningiomas are the most frequent primary tumors arising in the central nervous system. They typically follow a benign course, with an excellent prognosis for grade I... (Review)
Review
Meningiomas are the most frequent primary tumors arising in the central nervous system. They typically follow a benign course, with an excellent prognosis for grade I lesions through surgical intervention. Although radiotherapy is a good option for recurrent, progressive, or inoperable tumors, alternative treatments are very limited. mTOR is a protein complex with increasing therapeutical potential as a target in cancer. The current understanding of the mTOR pathway heavily involves it in the development of meningioma. Its activation is strongly dependent on PI3K/Akt signaling and the merlin protein. Both factors are commonly defective in meningioma cells, which indicates their likely function in tumor growth. Furthermore, regarding molecular tumorigenesis, the kinase activity of the mTORC1 complex inhibits many components of the autophagosome, such as the ULK1 or Beclin complexes. mTOR contributes to redox homeostasis, a vital component of neoplasia. Recent clinical trials have investigated novel chemotherapeutic agents for mTOR inhibition, showing promising results in resistant or recurrent meningiomas.
Topics: Animals; Humans; Meningeal Neoplasms; Meningioma; Neoplasm Recurrence, Local; Signal Transduction; TOR Serine-Threonine Kinases
PubMed: 35216092
DOI: 10.3390/ijms23041978 -
Journal of Neuropathology and... Nov 2022Meningioma is the most common intracranial neoplasm, yet there is no effective therapy for recurrent/refractory meningiomas after surgery and radiation....
Meningioma is the most common intracranial neoplasm, yet there is no effective therapy for recurrent/refractory meningiomas after surgery and radiation. Prostate-specific membrane antigen (PSMA) is an enzyme upregulated on endothelial cells of multiple neoplasms and is being investigated as a theranostic target. Until now, PSMA has not been studied in meningiomas. We aimed to verify PSMA endothelial expression in meningiomas, detect tumor grade variability, and investigate the relationship of PSMA signal with tumor recurrence. We analyzed 96 archival meningiomas including 58 de novo and 38 recurrent specimens. All specimens were stained routinely and immunostained for CD31 and PSMA. Slides were scanned and analyzed producing raw data for images of PSMA, CD31, PSMA/CD31, and PSMA/vasculature. PSMA expression was seen within 98.9% of meningioma samples. In the total cohort, higher-grade tumors had increased expression of raw PSMA and PSMA/CD31, and PSMA/vasculature ratios compared to grade 1 tumors. PSMA expression and PSMA/vasculature ratios (p = 0.0015) were higher in recurrent versus de novo tumors among paired samples. ROC curves demonstrated PSMA/CD31, PSMA/vasculature, and raw CD31 as indicators of tumor recurrence. Thus, PSMA is expressed within endothelial cells of meningiomas, is increased with tumor grade and recurrence, and persists with prior irradiation.
Topics: Humans; Male; Meningioma; Neoplasm Recurrence, Local; Precision Medicine; Endothelial Cells; Prostate; Meningeal Neoplasms
PubMed: 36179256
DOI: 10.1093/jnen/nlac089