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Volumetric growth rate of incidentally found meningiomas on immunotherapy

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Abstract

Purpose

The expression of PD-L1 in high-grade meningiomas made it a potential target for immunotherapy research in refractory cases. Several prospective studies in this field are still on going. We sought to retrospectively investigate the effects of check-point inhibitors (CI) on meningiomas that had been naïve to either surgical or radiation approaches by following incidental meningiomas found during treatment with CI for various primary metastatic cancers.

Methods

We used the NYU Perlmutter Cancer Center Data Hub to find patients treated by CI for various cancers, who also had serial computerized-tomography (CT) or magnetic-resonance imaging (MRI) reports of intracranial meningiomas. Meningioma volumetric measurements were compared between the beginning and end of the CI treatment period. Patients treated with chemotherapy during this period were excluded.

Results

Twenty-five patients were included in our study, of which 14 (56%) were on CI for melanoma, 5 (20%) for non-small-cell lung cancer and others. CI therapies included nivolumab (n = 15, 60%), ipilimumab (n = 11, 44%) and pembrolizumab (n = 9, %36), while 9 (36%) were on ipilimumab/nivolumab combination. We did not find any significant difference between tumor volumes before and after treatment with CI (1.31 ± 0.46 vs. 1.34 ± 0.46, p=0.8, respectively). Among patients beyond 1 year of follow-up (n = 13), annual growth was 0.011 ± 0.011 cm3/year. Five patients showed minor volume reduction of 0.12 ± 0.10 cm3 (21 ± 6% from baseline). We did not find significant predictors of tumor volume reduction.

Conclusion

Check-point inhibitors may impact the natural history of meningiomas. Additional research is needed to define potential clinical indications and treatment goals.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors would like to thank Megan D. Winner, MD, Victoria Lam, MS and Teija Hebshibah, MS from the Perlmutter Cancer Center Data Hub for providing support and data access for the purpose of this study.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Assaf Berger and Reed Mullen contributed equally to this work.

Authors and Affiliations

  1. Department of Neurological Surgery, NYU Langone Health Medical Center, New York University, New York, USA

    Assaf Berger, Reed Mullen, Elad Mashiach, Ying Meng, John G. Golfinos & Douglas Kondziolka

  2. Department of Radiation Oncology, NYU Langone Health Medical Center, New York University, New York, USA

    Kenneth Bernstein, Joshua S. Silverman & Erik P. Sulman

  3. Functional Neurosurgery and Stereotactic Radiosurgery, University at Buffalo Neurosurgery (UBNS), NYU Langone Medical Center, 40 George Karl Blvd, 14221, Williamsville, NY, USA

    Assaf Berger

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  1. Assaf Berger
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Contributions

AB and RM contributed to the study conception and design, data preparation and analysis were performed by AB, RM, KB and EM. The first draft of the manuscript was written by AB and RM and all authors reviewed previous versions of the manuscript and approved the final manuscript.

Corresponding author

Correspondence to Assaf Berger.

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Ethics approval

The study was approved by the NYU Langone Health Institutional Review Board.

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The authors declare no competing interests.

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Berger, A., Mullen, R., Bernstein, K. et al. Volumetric growth rate of incidentally found meningiomas on immunotherapy. J Neurooncol 166, 303–307 (2024). https://doi.org/10.1007/s11060-023-04558-2

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