Functional precision medicine assay for recurrent meningioma: a proof of principle. Illustrative case.

Autor:	Shelton WJ; Departments of Neurosurgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Santos Horta E; Departments of Medical Oncology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Stephen Nix J; Departments of Pathology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Gokden M; Departments of Pathology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Rodriguez A; Departments of Neurosurgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2024 Jul 29; Vol. 8 (5). Date of Electronic Publication: 2024 Jul 29 (Print Publication: 2024).
DOI:	10.3171/CASE24242
Abstrakt:	Background: Meningiomas are the most prevalent primary central nervous system tumors. Although low-grade meningiomas are considered benign tumors, a subset of these can behave aggressively, showing progression and recurrence. In such cases, functional assays could influence treatment decisions and improve patient outcomes. Observations: A 78-year-old female presented with a long-standing history of a supratentorial meningioma that was initially resected and treated with Gamma Knife radiosurgery. Surveillance revealed progression. She began systemic therapy with everolimus and octreotide but was lost to follow-up and did not continue the treatment. She returned because of a rapid decline in her neurological status. Biopsy with advanced molecular characterization by next-generation sequencing revealed NF2 and CREBBP mutations, and a commercial functional assay was done. This assay successfully isolated cancer stem cells (CSCs) from biopsy cores and identified potential drugs based on cellular sensitivity profiles. This is the first reported case in which a commercial functional drug screen was used for a meningioma. Lessons: In cases in which meningiomas exhibit specific genetic alterations and characteristics of aggressiveness, functional assays can be a useful tool for isolating CSCs. The authors report success in obtaining drug-screen profiling for a World Health Organization grade 1 meningioma. Multimodal approaches utilizing multi-omics analyses with functional assays can improve patient outcomes. https://thejns.org/doi/10.3171/CASE24242.
Databáze:	MEDLINE
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