DNA methylation analysis for the treatment of meningiomas

Gendreau, Julian; Chow, Kevin; Sussman, Eric S; Iyer, Aditya; Pendharkar, Arjun V; Ho, Allen L.

doi:10.21037/jovs.2017.11.01

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Whether there are certain biological alternations of meningiomas related to their location that makes them susceptible to recurrence is not known to date. Especially the close proximately to the falx cerebri and/or superior sagittal sinus has been reported to preclude radical surgery leading to higher recurrence rates (35,36), as illustrated in Fig. 2A, although the results are not always consistent throughout the literature (5,37).…”

Section: Discussionmentioning

confidence: 94%

“…In addition, retrospective studies have shown prolonged survival from adjuvant stereotactic radiosurgery when delivered promptly after resection rather than at regrowth, emphasizing the importance of a sensitive and specific noninvasive imaging technique in patient selection, radiotherapy planning, and subsequent imaging surveillance (10,12,41). Furthermore, the routine clinical use of [ 68 Ga]Ga-DOTA-TOC PET may be particular important in patients with meningioma with GTR on MRI, where the molecular features, for example, TERT mutation or a progressive phenotype based on nextgeneration sequencing or clinical behavior would support early radiotherapy (35,42). Finally, the high prevalence of active tumor residue has implications for the inclusion of patients with allegedly reported GTR on MRI into randomized controlled trials (43), which may in turn lead to erroneous conclusions regarding treatment efficacy, e.g., if tumor residues are either missed or not located in the radiation treatment field.…”

Section: Discussionmentioning

confidence: 99%

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Improved Detection of Postoperative Residual Meningioma with [68Ga]Ga-DOTA-TOC PET Imaging Using a High-resolution Research Tomograph PET Scanner

Bashir

Larsen

Ziebell

et al. 2021

Clinical Cancer Research

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Purpose: PET with somatostatin receptor ligand [ 68 Ga]Ga-DOTA-D-Phe 1 -Tyr 3 -octreotide ([ 68 Ga]Ga-DOTA-TOC) is an established method in radiotherapy planning because of the improved detection and delineation of meningioma tissue. We investigated the diagnostic accuracy of supplementary [ 68 Ga]Ga-DOTA-TOC PET in patients with a 3-month postoperative MRI reporting gross-total resection (GTR).Experimental Design: Thirty-seven patients with a histologically proven meningioma and GTR on postoperative MRI were prospectively referred to [ 68 Ga]Ga-DOTA-TOC PET. Detection and volume measurements of [ 68 Ga]Ga-DOTA-TOC-avid lesions in relation to the primary tumor site were recorded. Residual tumor in suspicious lesions suggested by [ 68 Ga]Ga-DOTA-TOC PET was verified by (i) tumor recurrence/progression on subsequent MRI scans according to the Response Assessment of Neuro-Oncology criteria, (ii) subsequent histology, and (iii) follow-up [ 68 Ga]Ga-DOTA-TOC PET scan.Results: Twenty-three PET scans demonstrated [ 68 Ga]Ga-DOTA-TOC-avid lesions suspicious of residual meningioma, where 18 could be verified by (i) tumor progression on subsequent MRI scans (n ¼ 6), (ii) histologic confirmation (n ¼ 3), and (iii) follow-up [ 68 Ga]Ga-DOTA-TOC PET scans confirming the initial PET findings (n ¼ 9) after an overall median follow-up time of 17 months (range, 9-35 months). In contrast, disease recurrence was seen in only 2 of 14 patients without [ 68 Ga]Ga-DOTA-TOC-avid lesions (P < 0.0001). The sensitivity, specificity, and diagnostic accuracy of [ 68 Ga]Ga-DOTA-TOC PET in detecting meningioma residue was 90% [95% confidence interval (CI), 67-99], 92% (95% CI, 62-100), and 90% (95% CI, 74-98; P < 0.0001), respectively.Conclusions: The majority of patients with GTR on 3-month postoperative MRI may have small unrecognized meningioma residues that can be detected using [ 68 Ga]Ga-DOTA-TOC PET.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Improved Detection of Postoperative Residual Meningioma with [68Ga]Ga-DOTA-TOC PET Imaging Using a High-resolution Research Tomograph PET Scanner

Bashir

Larsen

Ziebell

et al. 2021

Clinical Cancer Research

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The Genomic Landscape of Meningiomas

Zhao¹,

Youngblood

Erson‐Omay

et al. 2020

Meningiomas

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DNA methylation meningioma biomarkers: attributes and limitations

Gao

Zhang

et al. 2023

Front. Mol. Neurosci.

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Meningioma, one of the most common primary central nervous system tumors, are classified into three grades by the World Health Organization (WHO) based on histopathology. The gold-standard treatment, surgical resection, is hampered by issues such as incomplete resection in some cases and a high recurrence rate. Alongside genetic alterations, DNA methylation, plays a crucial role in progression of meningiomas in the occurrence and development of meningiomas. The epigenetic landscape of meningioma is instrumental in refining tumor classification, identifying robust molecular markers, determining prognosis, guiding treatment selection, and innovating new therapeutic strategies. Existing classifications lack comprehensive accuracy, and effective therapies are limited. Methylated DNA markers, exhibiting differential characteristics across varying meningioma grades, serve as invaluable diagnostic tools. Particularly, combinatorial methylated markers offer insights into meningioma pathogenesis, tissue origin, subtype classification, and clinical outcomes. This review integrates current research to highlight some of the most promising DNA and promoter methylation markers employed in meningioma diagnostics. Despite their promise, the development and application of DNA methylation biomarkers for meningioma diagnosis and treatment are still in their infancy, with only a handful of DNA methylation inhibitors currently clinically employed for meningioma treatment. Future studies are essential to validate these markers and ascertain their clinical utility. Combinatorial methylated DNA markers for meningiomas have broad implications for understanding tumor development and progression, signaling a paradigm shift in therapeutic strategies for meningiomas.

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DNA methylation analysis for the treatment of meningiomas

Cited by 3 publications

References 12 publications

Improved Detection of Postoperative Residual Meningioma with [68Ga]Ga-DOTA-TOC PET Imaging Using a High-resolution Research Tomograph PET Scanner

Improved Detection of Postoperative Residual Meningioma with [68Ga]Ga-DOTA-TOC PET Imaging Using a High-resolution Research Tomograph PET Scanner

The Genomic Landscape of Meningiomas

DNA methylation meningioma biomarkers: attributes and limitations

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