Treatment Of Malignant Meningiomas Research Articles

The FGF6 amplification mutation plays an important role in the progression and treatment of malignant meningioma

Meningioma is a benign tumor with slow growth and long course. However, patients with recurrent malignant meningioma still face a lack of effective treatment. Here, we report a rare case of primary mediastinal malignant meningioma with lung and bone metastases, who benefited from the treatment of apatinib (≥33 months) and anlotinib (until the publication date). Retrospective molecular analysis revealed the frequent amplification of FGF6 in primary and metastatic lesions. Then we constructed the FGF6 over-expressed IOMM-LEE and CH157MN malignant meningioma cell lines, and in vitro and vivo experiments showed that overexpression of FGF6 can promote the proliferation, migration and invasion of malignant meningioma cells. Based on the Western analysis, we revealed that FGF6 can promote the phosphorylation of FGFR, AKT, and ERK1/2, which can be inhibited by anlotinib. Together, we were the first to verify that overexpression of FGF6 promotes the progression of malignant meningiomas by activating FGFR/AKT/ERK1/2 pathway and pointed out that anlotinib may effectively inhibit the disease progression of patients with FGF6 amplification.

1245 Malignant Meningioma Survival, Recurrence and Functional Outcomes in an International Multicenter Cohort

INTRODUCTION: Meningiomas are the most common intracranial tumor. Grade 3 (malignant) meningiomas are the most aggressive subtype and represent 1-3% of all meningiomas cases. METHODS: Demographic, clinical and histopathological data from grade 3 intracranial meningioma cases were identified in the clinical databases from seven sites in North America and Europe from 1991-2022. Summary statistics and Kaplan-Meier OS and PFS curves were generated. RESULTS: We identified 108 patients, with a median age 65 years (IQR: 52, 72) and 53.7% were female. Median OS was 109 months (95% CIs: 88, 227) and 5-year OS rate was 65% (95% CIs: 56, 76). Median PFS was 38 months (95% CIs: 24, 56) and 5-year PFS rate was 37% (95% CIs: 28, 49). Older age (=65 years old) and male sex were independent predictors of worse OS and PFS in multivariate regression analysis. Postoperative radiotherapy was independently associated with improved OS in all patients and a sensitivity analysis including only patients =65 years old. Functional status, as measured by Karnofsky performance status, was stable between preoperative (median: 80 [IQR: 70, 90]), postoperative (median: 90 [IQR: 70, 98]) and 1-year postoperative (median: 70 [IQR: 50, 80]) timepoints. CONCLUSIONS: This study provides robust survival, recurrence, and functional outcome data for malignant meningiomas in North America and Europe over a 30-year period. We demonstrate that older age and male sex are associated with worse survival and recurrence outcomes. We further affirm that adjuvant radiotherapy confers a survival benefit in the treatment of malignant meningiomas, including in patients older than 65 years. Despite concerns around surgical and radiotherapy treatment complications, functional status remains stable in the first year following treatment of malignant meningiomas.

Prognostic factors and Doxorubicin involved in malignant progression of meningioma

Meningioma was the most primary intracranial tumor, but the molecular characteristics and the treatment of malignant meningioma were still unclear. Nine malignant progression-related genes based prognostic signatures were identified by transcriptome analysis between benign meningioma and malignant meningioma. The external dataset GEO136661 and quantitative Real-time Polymerase Chain Reaction were used to verify the prognostic factors. has-miR-3605-5p, hsa-miR-664b-5p, PNRC2, BTBD8, EXTL2, SLFN13, DGKD, NSD2, and BVES were closed with malignant progression. Moreover, Doxorubicin was identified by Connectivity Map website with the differential malignant progression-related genes. CCK-8 assay, Edu assay, wound healing assay, and trans-well experiment were used to reveal that Doxorubicin could inhibit proliferation, migration and invasion of IOMM-Lee Cells.

The applications of medical thermography in alfitherapy

Recently, medical thermography has attracted more and more attention from physicians and physiologists, especially in the study of complex diseases. Thermograms show the distribution of thermal fields, corresponding or not corresponding to normal thermography of specific areas. The presence of a pathological thermal picture indicates a certain pathology. Medical thermography makes it possible to conduct an examination in a short time (5-10 minutes) with the construction of accurate heat maps and is a safe method of primary diagnosis. Infrared thermal mapping provides a study of the development of a thermoactive process in time, which increases the diagnostic capabilities of the method, especially in the early stages of disease development. The aim of this work is to study the possibilities of medical thermography in the treatment of malignant meningioma by the method of alfitherapy. Alphitherapy (algo – algae, phyto– plants) is a direction in medicine, veterinary medicine, cosmetology, which is distinguished by the fact that it allows you to completely restore the entire body and get rid of hormonal, chronic, acute and concomitant diseases due to a proper balanced diet, which consists of algae, plants, macro- and microelements, vitamins with the presence of plant microorganisms. The data obtained as a result of many years of research indicate that alpha drugs contain a rich set of biologically active substances with versatile pharmacological activity, which are successfully used to treat a wide range of cardiovascular and oncological diseases, injuries and other health disorders. The results of application of the method of medical thermography in alfitherapy based on the portable thermograph IRTIS-2000 ME are presented. A patient was considered whose results of thermographic examination revealed malignant meningioma (brain cancer). As a result of the use of the alfitherapy method, the malignant meningioma was completely cured without surgery. A description of the biological mechanisms of alfitherapy and alfitherapeutic action for the treatment of cardiovascular and oncological diseases is given. The areas of application of medical thermography in medical diagnostics are presented. It has been shown that the use of medical thermography allows non-invasive primary diagnostics and monitoring of the state of human health, and alfitherapy allows effective non-surgical restoration of the whole organism, regardless of nosology.

947 POSTER Target volume reduction in the treatment of malignant meningioma by boron neutron capture therapy

947 POSTER Target volume reduction in the treatment of malignant meningioma by boron neutron capture therapy

The Treatment of Malignant Meningioma with Verotoxin

Malignant meningiomas (MMs) are aggressive intracranial neoplasms with a 75% 5-year recurrence rate. Verotoxin 1 (VTi) is an Escherichia coli toxin, which has recently been shown to have anti-neoplastic action by targeting the globotriosylceramide (Gb3) glycolipid on tumor cells and tumor neovasculature. To investigate the potential use of VTi as a clinical agent for MM, we initially tested 16 meningiomas for Gb3 expression. Nine of 11 MMs (82%), but only one of five benign meningiomas (20%), were positive for Gb3. An orthotopic xenograft model was used to test the efficacy of VTi treatment for MM. We first demonstrated that Gb3 was highly expressed by the MM cell line, IOMM-Lee, and that this cell line was highly sensitive to VTi treatment in vitro. A single intratumoral injection of VTi significantly improved survival in nude mice harboring intracranial tumours (P<.0001). Factor-eight immunostaining of tumours harvested from VTi-treated animals revealed a marked reduction in the tumour microvascular density. In addition, the tumors of VTi-treated animals displayed increased apoptosis by TUNEL analysis and showed a significant decrease in cell proliferation, as determined by MIB-5 immunostaining. VTi treatment of MM is effective in our orthotopic xenograft model, and warrants further exploration as a potential treatment for these highly anaplastic and aggressive neoplasms.

The role of radiotherapy in the treatment of malignant meningiomas

Most malignant meningiomas will recur following surgical resection only. The role of irradiation and radiation dose levels is poorly defined. This study reviews a single institution experience using both, conventional and high doses > or = 60 Gy/CGE radiation regimen. Between 1974 and 1995 16 patients with histologically proven malignant meningioma underwent radiation therapy (RT). Age at diagnosis ranged between 6 and 79 years (median: 49 years). Three patients reported previous irradiation to the head at least 14 years prior to diagnosis. Ten patients were treated for primary, and 6 patients for recurrent disease. Six patients underwent gross total and 10 patients subtotal resection (Table 1). RT was delivered using conventional, megavoltage photons or combined 160 MeV proton and photon irradiation. Except 1 patient, who died during RT, the radiation doses ranged between 40 and 70 Gy/CGE (= Cobalt Gray Equivalent) (median: 58 Gy/CGE, Table 2). With median observation time of 59 months (range: 10 to 155 months), actuarial local control rates at 5 and 8 years were 52% and 17%, respectively. Target doses > or = Gy/CGE resulted in significantly improved tumor control (100%) compared to < 60 Gy/CGE (17%) (p = 0.0006, Table 3 and Figure 1). Improved local control translated also in increased overall survival: 87% (> or = 60 Gy/CGE) versus 15% (< 60 Gy/CGE) at 5 years (p = 0.025, Figure 2). At time of analysis, 6/16 patients (38%) were alive. Two patients developed symptomatic brain damage at doses of 59.3 and 72 Gy/CGE. Conformal, radiation therapy with target doses > or = 60 Gy/CGE, in this study by use of combined proton and photon irradiation, can significantly improve chances of long-term local control and survival for patients diagnosed with these challenging tumors.