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Updated: Jul 6, 2025
Translational Orthotopic Models of Glioblastoma Multiforme
Published on: February 17, 2023
Volumetric growth rate of incidentally found meningiomas on immunotherapy
Assaf Berger1,2, Reed Mullen3, Kenneth Bernstein4
1Department of Neurological Surgery, NYU Langone Health Medical Center, New York University, New York, USA. aberger@ubns.com.
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.
Insights
Check-point inhibitors (CI) did not significantly alter meningioma volumes in patients treated for other cancers. Further research is needed to explore potential clinical uses of CI for meningiomas.
Area of Science:
- Neuro-oncology
- Immunotherapy
- Radiology
Background:
- High-grade meningiomas express PD-L1, making them potential targets for immunotherapy.
- Prospective studies on immunotherapy for meningiomas are ongoing.
- Immune checkpoint inhibitors (CI) are a class of immunotherapy drugs.
Purpose of the Study:
- To retrospectively investigate the effects of CI on incidental meningiomas.
- To assess changes in meningioma volume during CI treatment for other primary metastatic cancers.
- To evaluate if CI impacts the natural history of treatment-naïve meningiomas.
Main Methods:
- Retrospective analysis of patients treated with CI at NYU Perlmutter Cancer Center.
- Inclusion criteria: patients with intracranial meningiomas and serial CT/MRI scans during CI therapy.
- Exclusion criteria: patients receiving chemotherapy concurrently with CI.
Main Results:
- Twenty-five patients were included; most received CI for melanoma or non-small-cell lung cancer.
- No significant difference in meningioma volume before and after CI treatment (p=0.8).
- Minor volume reduction observed in 5 patients (21% from baseline); no significant predictors identified.
Conclusions:
- CI may influence the natural course of meningiomas.
- Further research is warranted to determine clinical indications and treatment goals for CI in meningiomas.
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