Paths of Evolution of Progressive Anaplastic Meningiomas: A Clinical and Molecular Pathology Study

Rina Di Bonaventura, Liverana Lauretti, Maurizio Martini, Tonia Cenci, Giuliano Di Monaco, Davide Palombi, Giovanni Maria Ceccarelli, Silvia Chiesa, Marco Gessi, Alessia Granitto, Alessio Albanese, Luigi Maria Larocca, Quintino Giorgio D'Alessandris*, Roberto Pallini, Alessandro Olivi

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Grade 3 meningiomas are rare malignant tumors that can originate de novo or from the progression of lower grade meningiomas. The molecular bases of anaplasia and progression are poorly known. We aimed to report an institutional series of grade 3 anaplastic meningiomas and to investigate the evolution of molecular profile in progressive cases. Clinical data and pathologic samples were retrospectively collected. VEGF, EGFR, EGFRvIII, PD-L1; and Sox2 expression; MGMT methylation status; and TERT promoter mutation were assessed in paired meningioma samples collected from the same patient before and after progression using immunohistochemistry and PCR. Young age, de novo cases, origin from grade 2 in progressive cases, good clinical status, and unilateral side, were associated with more favorable outcomes. In ten progressive meningiomas, by comparing molecular profile before and after progression, we identified two subgroups of patients, one defined by Sox2 increase, suggesting a stem-like, mesenchymal phenotype, and another defined by EGFRvIII gain, suggesting a committed progenitor, epithelial phenotype. Interestingly, cases with Sox2 increase had a significantly shortened survival compared to those with EGFRvIII gain. PD-L1 increase at progression was also associated with worse prognosis, portending immune escape. We thus identified the key drivers of meningioma progression, which can be exploited for personalized treatments.
Lingua originaleEnglish
pagine (da-a)206-206
Numero di pagine1
RivistaJournal of Personalized Medicine
Volume13
DOI
Stato di pubblicazionePubblicato - 2023

Keywords

  • EGFRvIII
  • PD-L1
  • Sox2
  • anaplastic
  • meningioma
  • progression

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