Article Figures & Data
Figures
- FIG 1.
A, Kaplan-Meier curve comparing the PFS of patients with de novo (green) versus secondary-progressive (blue) WHO grade 3 meningioma. B, Kaplan-Meier curve comparing the PFS of patients with secondary-progressive WHO grade 3 meningioma who underwent GTR (green) versus subtotal resection (STR) (blue). PFS was determined using the RANO criteria on follow-up MR imaging post-initial surgery diagnosing WHO grade 3 meningioma.
- FIG 2.
Comparison of the number of genomic alternations per tumor between de novo versus secondary-progressive (SP) WHO grade 3 meningiomas. The Mann-Whitney test was performed to test statistical significance. A single asterisk indicates P value < .05.
- FIG 3.
SUV on (68Ga) DOTATATE PET/MR of de novo–versus–secondary-progressive (SP) WHO grade 3 meningioma lesions. The Mann-Whitney test was performed to test the statistical significance. Double asterisks indicate P value < .01.
- FIG 4.
Representative cases of DOTATATE-PET/MR imaging and corresponding T1-weighted postcontrast images of a patient with de novo WHO grade 3 meningioma (left) and a patient with secondary-progressive WHO 3 meningioma (right).
Tables
- Table 1:
Comparison of demographics, surgical, and radiation history, PFS, molecular pathology, and SUV on (68Ga) DOTATATE PET between patients with de novo–versus–secondary-progressive WHO grade 3 meningiomaa
De Novo WHO Grade 3 Secondary-Progressive WHO Grade 3 No. of Patients 7 7 Age (mean) (yr) 69.1 (range, 46–80) 62.6 (range, 43–81) Sex 28% female (2/7) 58% female (4/7) P = .59 Median No. of distinct lesions 3 7 P = .13 Percentage of patients with extracranial metastasis 13% (1/7) 43% (3/7) P = .56 Average total number of surgeries per patient 1.6 4.1 (2.3) P = .011 Average total rounds of RT per patient 1.6 2.4 (1.1) P = .23 Average total cumulative radiation dose per patient 68.3 Gy 106 Gy P = .31 PFS (median) 37.7 mo 4.8 mo P = .004 Recurrence or progression to date 71% (5/7) 100% (7/7) P = .46 Average No. of genomic alterations per tumor 1.3 (range, 0–3) 3.6 (range, 1–6) P = .037 Average maximum SUV of (68Ga) DOTATATE 12.4 (range, 4.1–58.7) 17.1 (range, 4.7–99.4) P = .0021 ↵a For the secondary-progressive WHO grade 3 cohort, the number of surgical and radiation treatments reported reflects patients’ entire clinical course, while the number in parentheses reflects treatment that occurred after degeneration into WHO grade 3.
- Table 2:
Summary of molecular pathology profiling through the Oncomine Comprehensive Assay across 5 samples in the de novo cohort as well as 6 samples from secondary-progressive cohorta
De Novo (D.N.)/Secondary Progressive (S.P.) Pathogenic Variants Variants of Unknown Significance WHO Grade at Time of Analysis S.P. CDKN2A loss
CDKN2B loss
FANCG splice site deletion
MTAP loss
TP53 V31L
– 3 S.P. ARID1 frameshift alteration
FBXW7 frameshift deletion
TSC2 in frame insertion
CDH1 missense
3 S.P. NF2 nonsense
CDKN2A deletion
– 3 S.P. MSH2 nonsense
TP53 nonsense
PTEN frameshift deletion
GNAS missense
– 2 S.P. – PIK3R1 missense
TSC1 missense
NOTCH1 missense
NF2 missense
2 S.P. NF2 splice site
CDKN2A deletion
– 1 D.N. BRCA2 frameshift deletion
NF2 nonsense
BRCA2 missense
3 D.N. – CCND1 amplification
RPS6KB1 amplification
3 D.N. – ATM missense
3 D.N. – – 3 D.N. – – 3 Note:—The en dash indicates no mutations found.
↵a Notably, the 6 samples from the secondary-progressive cohort included 1 sample that was WHO grade 1, two samples that were WHO grade 2, and 3 samples that were WHO grade 3 at the time of genetic analysis. Mutations were stratified by clinical significance and categorized as either pathogenic or variants of unknown significance. TERT promoter mutations were not included in this panel.
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