1. Molecular classification to refine surgical and radiotherapeutic decision-making in meningioma.
- Author
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Wang, Justin, Patil, Vikas, Landry, Alexander, Gui, Chloe, Ajisebutu, Andrew, Liu, Jeff, Saarela, Olli, Pugh, Stephanie, Won, Minhee, Patel, Zeel, Yakubov, Rebeca, Kaloti, Ramneet, Wilson, Christopher, Cohen-Gadol, Aaron, Zaazoue, Mohamed, Tabatabai, Ghazaleh, Tatagiba, Marcos, Behling, Felix, Almiron Bonnin, Damian, Holland, Eric, Kruser, Tim, Barnholtz-Sloan, Jill, Sloan, Andrew, Horbinski, Craig, Chotai, Silky, Chambless, Lola, Gao, Andrew, Rebchuk, Alexander, Makarenko, Serge, Yip, Stephen, Sahm, Felix, Maas, Sybren, Tsang, Derek, Rogers, C, Aldape, Kenneth, Nassiri, Farshad, and Zadeh, Gelareh
- Subjects
Meningioma ,Humans ,Meningeal Neoplasms ,Female ,Male ,Middle Aged ,Aged ,Retrospective Studies ,Clinical Decision-Making ,Adult ,Progression-Free Survival ,Biomarkers ,Tumor ,Treatment Outcome ,Decision Making - Abstract
Treatment of the tumor and dural margin with surgery and sometimes radiation are cornerstones of therapy for meningioma. Molecular classifications have provided insights into the biology of disease; however, response to treatment remains heterogeneous. In this study, we used retrospective data on 2,824 meningiomas, including molecular data on 1,686 tumors and 100 prospective meningiomas, from the RTOG-0539 phase 2 trial to define molecular biomarkers of treatment response. Using propensity score matching, we found that gross tumor resection was associated with longer progression-free survival (PFS) across all molecular groups and longer overall survival in proliferative meningiomas. Dural margin treatment (Simpson grade 1/2) prolonged PFS compared to no treatment (Simpson grade 3). Molecular group classification predicted response to radiotherapy, including in the RTOG-0539 cohort. We subsequently developed a molecular model to predict response to radiotherapy that discriminates outcome better than standard-of-care classification. This study highlights the potential for molecular profiling to refine surgical and radiotherapy decision-making.
- Published
- 2024