Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients

Neuro-Oncology, Journal Year: 2024, Volume and Issue: 26(10), P. 1742 - 1780

Published: May 2, 2024

Abstract Meningiomas are the most common primary intracranial tumors in adults and increasing incidence due to aging population increased access neuroimaging. While exhibit nonmalignant behavior, a subset of meningiomas biologically aggressive associated with treatment resistance, resulting significant neurologic morbidity even mortality. In recent years, meaningful advances our understanding biology these have led incorporation molecular biomarkers into their grading prognostication. However, unlike other central nervous system (CNS) tumors, unified taxonomy for has not yet been established remains an overarching goal Consortium Inform Molecular Practical Approaches CNS Tumor Taxonomy-Not Official World Health Organization (cIMPACT-NOW) working group. Additionally, clinical equipoise still on how specific meningioma cases patient populations should be optimally managed. To address existing gaps, members International including field-leading experts, prepared this comprehensive consensus narrative review directed toward clinicians, researchers, patients. Included manuscript detailed overviews proposed classifications, novel biomarkers, contemporary strategies, trials systemic therapies, health-related quality-of-life studies, management strategies unique populations. each section, we discuss current state knowledge as well ongoing research challenges road map future directions further investigation.

Language: Английский

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Hormone Receptor Expression in Meningiomas: A Systematic Review

Cancers, Journal Year: 2023, Volume and Issue: 15(3), P. 980 - 980

Published: Feb. 3, 2023

Meningiomas are, in most cases, low grade intracranial tumors. However, relapses are frequent. To date, only a few prognostic markers described the literature. Several studies have discussed expression of progesterone, estrogen, androgen, and somatostatin receptors. The utility analyzing these expressions for prognostic, theragnostic, therapeutic purposes remains unclear. aim this study was to report receptors, based on immunohistochemistry. Cochrane Collaboration guidelines PRISMA statements were followed. We did an online search PubMed using MeSH database. References selected if investigations occurred from 1990 2022. 61 references included (34 descriptive observational studies, 26 analytical one case report). In review, we describe receptors function age, sex, hormonal context, localization, histological subtype, grade, recurrence.

Language: Английский

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Lutathera® Orphans: State of the Art and Future Application of Radioligand Therapy with 177Lu-DOTATATE

Pharmaceutics, Journal Year: 2023, Volume and Issue: 15(4), P. 1110 - 1110

Published: March 31, 2023

Lutathera® is the first EMA- and FDA-approved radiopharmaceutical for radioligand therapy (RLT). Currently, on legacy of NETTER1 trial, only adult patients with progressive unresectable somatostatin receptor (SSTR) positive gastroenteropancreatic (GEP) neuroendocrine neoplasms (NET) can be treated Lutathera®. Conversely, SSTR-positive disease arising from outside gastroenteric region do not currently have access to treatment despite several papers in literature reporting effectiveness safety RLT these settings. Moreover, well-differentiated G3 GEP-NET are also still “Lutathera orphans”, retreatment relapse approved. The aim this critical review summarize current evidence assessing role approved indications. ongoing clinical trials evaluating new possible applications will considered discussed provide an updated picture future investigations.

Language: Английский

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Multimodal brain tumor segmentation and classification from MRI scans based on optimized DeepLabV3+ and interpreted networks information fusion empowered with explainable AI

Computers in Biology and Medicine, Journal Year: 2024, Volume and Issue: 182, P. 109183 - 109183

Published: Oct. 2, 2024

Language: Английский

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Establishment of tumor microenvironment-preserving organoid model from patients with intracranial meningioma

Cancer Cell International, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 18, 2024

Abstract Background Although meningioma is the most common primary brain tumor, treatments rely on surgery and radiotherapy, recurrent meningiomas have no standard therapeutic options due to a lack of clinically relevant research models. Current cell lines or organoids cannot reflect biological features patient tumors since they undergo transformation along culture consist only tumor cells without microenvironment. We aim establish patient-derived (MNOs) preserving diverse types representative Methods The MNOs were evaluated using WST, LDH, collagen-based 3D invasion assays. Cellular identities in confirmed by immunohistochemistry (IHC). Genetic alteration profiles their corresponding parental obtained whole-exome sequencing. Results established from four patients with (two grade 1 two 2) at 100% succession rate. Exclusion enzymatic dissociation-reaggregation steps endowed original histology In addition, we used liquid media system instead embedding samples into Matrigel, resulting an easy-to-handle, cost-efficient, time-saving system. maintained functionality morphology after long-term (> 9 wk) repeated cryopreserving-recovery cycles. similarities between both IHC As application, utilized drug screening, mifepristone, antagonist progesterone receptor, showed prominent antitumor efficacy respect viability, invasiveness, protein expression. Conclusion Taken together, our MNO model overcame limitations previous models superior resemblance tumors. Thus, could facilitate translational identifying selecting drugs for era precision medicine.

Language: Английский

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LymphoDose: a lymphocyte dose estimation framework—application to brain radiotherapy

Physics in Medicine and Biology, Journal Year: 2024, Volume and Issue: 69(10), P. 105009 - 105009

Published: April 9, 2024

. Severe radiation-induced lymphopenia occurs in 40% of patients treated for primary brain tumors and is an independent risk factor poor survival outcomes. We developed

Language: Английский

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Inflammatory factors and risk of meningiomas: a bidirectional mendelian-randomization study

Frontiers in Neuroscience, Journal Year: 2023, Volume and Issue: 17

Published: June 22, 2023

Meningiomas are one of the most common intracranial tumors, and current understanding meningioma pathology is still incomplete. Inflammatory factors play an important role in pathophysiology meningioma, but causal relationship between inflammatory unclear.Mendelian randomization (MR) effective statistical method for reducing bias based on whole genome sequencing data. It's a simple powerful framework, that uses genetics to study aspects human biology. Modern methods MR make process more robust by exploiting many genetic variants may exist given hypothesis. In this paper, applied understand exposure disease outcome.This research presents comprehensive association cytokines with meningioma. Based results our analysis, which examines 41 largest GWAS datasets available, we were able draw relatively reliable conclusion elevated levels circulating TNF-β, CXCL1, lower IL-9 suggestive associated higher risk Moreover, could cause interleukin-16 CXCL10 blood.These findings suggest development meningiomas. also affect expression such as IL-16 CXCL10. Further studies needed determine whether these biomarkers can be used prevent or treat

Language: Английский

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Targeting histone deacetylase 6 (HDAC6) to enhance radiation therapy in meningiomas in a 2D and 3D in vitro study

EBioMedicine, Journal Year: 2024, Volume and Issue: 105, P. 105211 - 105211

Published: June 24, 2024

External radiation therapy (RT) is often a primary treatment for inoperable meningiomas in the absence of established chemotherapy. Histone deacetylase 6 (HDAC6) overexpression, commonly found cancer, acknowledged as driver cellular growth, and inhibiting HDACs holds promise improving radiotherapeutic efficacy. Downregulation HDAC6 facilitates degradation β-catenin. This protein key element Wnt/β-catenin signalling pathway, contributing to progression meningiomas.

Language: Английский

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CAR-T cells neurotoxicity from consolidated practice in hematological malignancies to fledgling experience in CNS tumors: fill the gap

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 13

Published: June 16, 2023

Chimeric antigen receptor (CAR-T) therapy has marked a paradigm shift in the treatment of hematological malignancies and represent promising growing field also solid tumors. Neurotoxicity is well-recognized common complication CAR-T at forefront concerns for CAR-based immunotherapy widespread adoption, as it necessitates cautious approach. The non-specific targeting cells against normal tissues (on-target off-tumor toxicities) can be life-threatening; likewise, immune-mediate neurological symptoms related to cell induced inflammation central nervous system (CNS) must precociously identified recognized possibly distinguished from deriving tumor itself. mechanisms leading ICANS (Immune effector Cell-Associated Syndrome) remain largely unknown, even if blood-brain barrier (BBB) impairment, increased levels cytokines, well endothelial activation are supposed involved neurotoxicity development. Glucocorticoids, anti-IL-6, anti-IL-1 agents supportive care frequently used manage patients with neurotoxicity, but clear therapeutic indications, supported by high-quality evidence do not yet exist. Since under investigation CNS tumors, including glioblastoma (GBM), understanding full profile brain tumors expanding strategies aimed limiting adverse events become imperative. Education physicians assessing individualized risk providing optimal management crucial make therapies safer adoptable clinical practice

Language: Английский

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Meningioma: Molecular Updates from the 2021 World Health Organization Classification of CNS Tumors and Imaging Correlates

American Journal of Neuroradiology, Journal Year: 2024, Volume and Issue: 46(2), P. 240 - 250

Published: June 6, 2024

ABSTRACT

Meningiomas, the most common primary intracranial neoplasms, account for over a third of CNS tumors. While traditionally viewed as benign, meningiomas can be associated with considerable morbidity, and specific meningioma subgroups display more aggressive behavior higher recurrence rates. The risk stratification has been primarily World Health Organization (WHO) histopathological grade extent resection. However, growing body literature highlighted value molecular characteristics in assessing risk. maintaining previous classification system, 5th edition 2021 WHO tumor (CNS5) book expands upon information to help guide management. CNS5 stratifies into three grades (1-3) based on histopathology criteria profile. pTERT mutations CDKN2A/B deletions now signify 3 increased Tumor location also correlates underlying mutations. Convexity spinal carry 22q deletion and/or NF2 mutations, while skull base have AKT1, TRAF7, SMO, PIK3CA MRI is imaging modality diagnosing treatment planning meningiomas, DOTATATE-PET offers supplementary beyond anatomical imaging. Herein, we review evolving landscape emphasizing imaging/genetic biomarkers, strategies relevant neuroradiologists. ABBREVIATIONS: AKT1=AKT serine/threonine kinase 1; BAP1=BRCA1-associated protein CDK4/6=Cyclin-dependent kinases 4 6; KLF4=Krüppel-like factor 4; NF2=Neurofibromatosis type 2; PIK3CA=Phosphatidylinositol-4,5-Bisphosphate 3-Kinase catalytic subunit alpha; POLR2A=RNA polymerase II A; SMO: Smoothened, frizzled class receptor; SMARCB1=SWItch/sucrose non-fermentable related, matrix associated, actin dependent regulator chromatin, subfamily b, member TERT=Telomerase reverse transcriptase; TRAF7=TNF receptor-associated 7

Language: Английский

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