Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Medical Scientist Training Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Department of Pharmacology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
World Neurosurg. 2022 Jun;162:e99-e119. doi: 10.1016/j.wneu.2022.02.108. Epub 2022 Mar 3.
Meningiomas are a common primary central nervous system tumor that lack a U.S. Food and Drug Administration-approved pharmacotherapy. Approximately 20%-35% of meningiomas are classified as higher grade with poor outcome, whereas patients with lower-grade meningiomas are known to have long-term neurologic deficits and reduced overall survival. Recent efforts to understand the epigenetic landscape of meningiomas have highlighted the importance of DNA methylation for predicting tumor outcomes and prognosis; therefore, inhibition of these pathways may present a viable therapy for these tumors.
In this study, we perform dose-response curves of decitabine, a DNA methyltransferase inhibitor, on patient-cultured tumors and meningioma cell lines.
Thirty total samples were evaluated, including 24 patient-cultured tumors and 6 established meningioma cell lines. Meningiomas were found to have a significant reduction in cell viability after decitabine treatment in a dose dependent manner. The effect was primarily driven by 11 of the 30 tumors in our cohort, or 36.7%. Decitabine significantly reduced cell viability across all grades, tumors from different sexes, recurrent and primary tumors, as well as tumors without a history of previous radiation. Surprisingly, our single radiation-induced tumor did demonstrate greater viability after decitabine treatment.
Our work has identified a potential drug candidate in decitabine for the treatment of meningiomas regardless of clinical subgroup. These data require further evaluation in preclinical models, and the conclusions based on clinical subgroups need to be evaluated in a larger cohort to achieve appropriate statistical power.
脑膜瘤是一种常见的原发性中枢神经系统肿瘤,目前尚无美国食品和药物管理局批准的药物治疗方法。大约 20%-35%的脑膜瘤被归类为高级别,预后不良,而低级别的脑膜瘤患者已知存在长期神经功能缺损和总生存时间缩短。最近,人们努力了解脑膜瘤的表观遗传学特征,强调了 DNA 甲基化对于预测肿瘤结果和预后的重要性;因此,抑制这些通路可能为这些肿瘤提供一种可行的治疗方法。
在这项研究中,我们对患者培养的肿瘤和脑膜瘤细胞系进行了地西他滨(一种 DNA 甲基转移酶抑制剂)的剂量反应曲线分析。
共评估了 30 个总样本,包括 24 个患者培养的肿瘤和 6 个已建立的脑膜瘤细胞系。结果发现,地西他滨处理后,脑膜瘤的细胞活力呈剂量依赖性显著降低。这种作用主要是由我们队列中的 30 个肿瘤中的 11 个(36.7%)驱动的。地西他滨显著降低了所有分级、不同性别、复发性和原发性肿瘤以及没有既往放疗史的肿瘤的细胞活力。令人惊讶的是,我们的单个放疗诱导的肿瘤在地西他滨处理后表现出更高的活力。
我们的工作已经确定了地西他滨作为治疗脑膜瘤的潜在候选药物,无论临床亚组如何。这些数据需要在临床前模型中进一步评估,并且基于临床亚组的结论需要在更大的队列中进行评估,以获得适当的统计能力。