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Primary Orthotopic Glioma Xenografts Recapitulate Infiltrative Growth and Isocitrate Dehydrogenase I Mutation

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Concurrent gliomas in patients with multiple sclerosis.

Katharina Sahm^1,2, Tobias Kessler^3,4, Philipp Eisele⁵

¹Department of Neurology, Medical Faculty Mannheim, Mannheim Center for Translational Neurosciences (MCTN), University of Heidelberg, Mannheim, Germany. k.sahm@dkfz.de.

Communications Medicine

|December 19, 2023

Summary

Multiple sclerosis (MS) does not affect glioma risk. Patients with concurrent MS and IDH-mutant gliomas face worse prognoses and increased MS activity post-radiation.

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Area of Science:

Neuro-oncology
Neuroimmunology
Oncology

Background:

Concurrent malignant brain tumors and multiple sclerosis (MS) are rare but offer insights into neuroimmunological mechanisms.
Studying this phenomenon aids in understanding the interplay between autoimmune demyelination and primary brain tumors.

Purpose of the Study:

To investigate the relationship between multiple sclerosis and glioma development.
To analyze clinical and molecular characteristics of diffuse gliomas in MS patients.
To assess the impact of MS on glioma prognosis and treatment outcomes.

Main Methods:

A multicenter cohort of 26 patients with both primary brain tumors and MS was analyzed.
Disease localization, tumor treatment-related MS activity, and molecular features of gliomas were examined.
Comparison of methylation patterns in gliomas from MS patients versus non-MS patients.

Main Results:

Multiple sclerosis neither predisposes to nor protects against glioma development.
IDH-mutant gliomas in MS patients showed worse prognosis (PFS 32 vs. 64 months) and reduced resection extent.
Differential methylation of immune-related loci (HLA, IL) was observed in MS patients' gliomas.
Radiotherapy for brain tumors increased inflammatory MS activity in 42% of patients.

Conclusions:

Low-grade gliomas should be considered in MS patients with specific lesion patterns.
Reduced tumor resection and increased MS activity post-radiation are key considerations for treatment decisions in MS patients with gliomas.