A Targeted Gene Expression Biomarker Predicts Clinic Low-Risk Meningioma Recurrence

Authors

Minh P Nguyen
Ramin A Morshed
Mark W Youngblood
Haley K Perlow
Calixto-Hope G Lucas
Akash J Patel
Joshua D Palmer
Craig M Horbinski
Stephen T Magill
William C Chen
David R Raleigh

Language

English

Publication Date

2-10-2025

Journal

Neuro-Oncology

DOI

10.1093/neuonc/noae198

PMID

39340366

PMCID

PMC11812033

PubMedCentral® Posted Date

9-28-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Despite reassuring clinical and histological features, low-grade meningiomas can recur after surgery. Targeted gene expression profiling improves risk stratification of meningiomas, but the utility of this approach for clinical low-risk meningiomas is incompletely understood.

Methods: This was a multicenter retrospective cohort study of meningiomas from patients who were treated at 4 institutions from 1992 to 2023. Adult patients with newly diagnosed or recurrent World Health Organization (WHO) grade 1 meningiomas that were treated with gross total resection (GTR) or subtotal resection (STR), or newly diagnosed WHO grade 2 meningiomas that were treated with GTR, were included. A 34-gene expression biomarker and gene expression risk score (continuous from 0 to 1) was evaluated in all samples.

Results: The study cohort was comprised of 723 patients, none of which were used for discovery or training of the gene expression biomarker and 265 of which were previously unreported. There were 626 WHO grade 1 meningiomas, 490 with GTR and 126 with STR, and 97 WHO grade 2 meningiomas with GTR. Targeted gene expression profiling classified 51.3% of clinical low-risk meningiomas as molecular intermediate-risk and 9.5% as molecular high-risk. Combining the gene expression biomarker with the extent of resection revealed that 19.8% of clinical low-risk meningiomas had unfavorable local freedom from recurrence (LFFR) and overall survival (OS), including 7.1% of newly diagnosed WHO grade 1 meningiomas with GTR. The risk score was prognostic for LFFR (HR per 0.1 increase in risk score 1.89, 95% CI: 1.58-2.25) across all WHO grades, extents of resection, and newly diagnosed or recurrent presentations.

Conclusions: Targeted gene expression profiling can identify clinical low-risk meningiomas that are likely to recur after surgery.

Keywords

Humans, Meningioma, Female, Male, Neoplasm Recurrence, Local, Meningeal Neoplasms, Biomarkers, Tumor, Retrospective Studies, Middle Aged, Aged, Prognosis, Gene Expression Profiling, Adult, Follow-Up Studies, Survival Rate, Aged, 80 and over, biomarker, brain tumor, gene expression, meningioma

Published Open-Access

yes

Recommended Citation

Nguyen, Minh P; Morshed, Ramin A; Youngblood, Mark W; et al., "A Targeted Gene Expression Biomarker Predicts Clinic Low-Risk Meningioma Recurrence" (2025). Duncan NRI Faculty and Staff Publications. 167.
https://digitalcommons.library.tmc.edu/duncar_nri_pub/167