Regression of all untreated lesions in multifocal low-grade meningioma following fractionated stereotactic radiotherapy-abscopal effect or spontaneous regression? : Case report and review of the literature.
Grade I Meningioma
Immune microenvironment
Immune response
Meningiomatosis
Neoplasms, nerve tissue
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
13 Jun 2024
13 Jun 2024
Historique:
received:
16
02
2024
accepted:
12
05
2024
medline:
14
6
2024
pubmed:
14
6
2024
entrez:
13
6
2024
Statut:
aheadofprint
Résumé
Abscopal effects have been reported predominantly in metastatic cancers, indicating a radiographic response in a lesion that has not been included in the radiotherapy target volume. The response is interpreted as a humoral immune response to radiotherapy-generated tumour-specific antigens. In this case study, we present the first histologically confirmed multifocal low-grade meningioma with spontaneous regression of all other lesions after conventionally fractionated stereotactic radiotherapy (RT). Two localisations, right frontal and right spheno-orbital, were resected at the time of the initial diagnosis in a 66-year-old woman. RT was performed 1 year later to a progressive occipital lesion at the cerebral falx. Regular magnetic resonance imaging (MRI) showed slightly decreasing tumour volume in untreated lesions 1 year after RT and continued during further follow-up. Up to > 7 years after treatment, MRI demonstrated an almost complete response of all initial lesions. Two prior reports with meningioma were published in one patient with an atypical meningioma after conventionally fractionated RT and another patient with an intracranial meningiomatosis after radiosurgery. This case study supports the concepts of treating only progressive or symptomatic meningioma lesions locally and careful regular MRI surveillance for further assessment. Potential active interventions to trigger an abscopal effect are currently not known. Further research of this beneficial effect for our patients should be supported.
Identifiants
pubmed: 38871938
doi: 10.1007/s00066-024-02248-0
pii: 10.1007/s00066-024-02248-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Nabrinsky E, Macklis J, Bitran J (2022) A review of the abscopal effect in the era of immunotherapy. Cureus 14:e29620
pubmed: 36321062
pmcid: 9604762
Ngwa W, Irabor OC, Schoenfeld JD, Hesser J, Demaria S, Formenti SC (2018) Using immunotherapy to boost the abscopal effect. Nat Rev Cancer 18:313–322
doi: 10.1038/nrc.2018.6
pubmed: 29449659
pmcid: 5912991
Hino C, Lee EW, Yang GY (2023) Harnessing the abscopal effect for gastrointestinal malignancies in the era of immunotherapy. J Gastrointest Oncol 14:1613–1625
doi: 10.21037/jgo-23-105
pubmed: 37435204
pmcid: 10331744
Panje C, Guckenberger M (2016) Abscopal responses of local radiotherapy combined with systemic immunotherapy in patients with metastatic solid tumors. Strahlenther Onkol 192:72–74
doi: 10.1007/s00066-015-0921-4
pubmed: 26545761
Herter JM, Kiljan M, Kunze S, Reinscheid M, Ibruli O, Cai J et al (2023) Influence of chemoradiation on the immune microenvironment of cervical cancer patients. Strahlenther Onkol 199:121–130
doi: 10.1007/s00066-022-02007-z
pubmed: 36251031
Kokowski K, Stangl S, Seier S, Hildebrandt M, Vaupel P, Multhoff G (2019) Radiochemotherapy combined with NK cell transfer followed by second-line PD‑1 inhibition in a patient with NSCLC stage IIIb inducing long-term tumor control: a case study. Strahlenther Onkol 195:352–361
doi: 10.1007/s00066-019-01434-9
pubmed: 30747241
pmcid: 6433810
Ruckert M, Deloch L, Fietkau R, Frey B, Hecht M, Gaipl US (2018) Immune modulatory effects of radiotherapy as basis for well-reasoned radioimmunotherapies. Strahlenther Onkol 194:509–519
doi: 10.1007/s00066-018-1287-1
pubmed: 29500551
Tsuchiya T, Someya M, Takada Y, Hasegawa T, Kitagawa M, Fukushima Y et al (2020) Association between radiotherapy-induced alteration of programmed death ligand 1 and survival in patients with uterine cervical cancer undergoing preoperative radiotherapy. Strahlenther Onkol 196:725–735
doi: 10.1007/s00066-019-01571-1
pubmed: 31953603
Golub D, Kwan K, Knisely JPS, Schulder M (2019) Possible Abscopal Effect Observed in Frontal Meningioma After Localized IMRT on Posterior Meningioma Resection Cavity Without Adjuvant Immunotherapy. Front Oncol 9:1109
doi: 10.3389/fonc.2019.01109
pubmed: 31681619
pmcid: 6813201
Aldakhil S, Mathieu D (2022) Abscopal effect leading to complete disappearance of extensive meningiomatosis after gamma knife radiosurgery: Case report. Front Surg 9:908645
doi: 10.3389/fsurg.2022.908645
pubmed: 35910481
pmcid: 9329627
Pereira ABJ, Nogueira de Almeida A, Pires de Aguiar PH, Paiva WS, Teixeira MJ, Nagahashi MSK (2019) Multiple Intracranial Meningiomas: A Case Series and Review of the Literature. World Neurosurg 122:e1536–e41
doi: 10.1016/j.wneu.2018.11.097
Garzon-Muvdi T, Bailey DD, Pernik MN, Pan E (2020) Basis for Immunotherapy for Treatment of Meningiomas. Front Neurol 11:945
doi: 10.3389/fneur.2020.00945
pubmed: 32982948
pmcid: 7483661
Dunn IF, Du Z, Touat M, Sisti MB, Wen PY, Umeton R et al (2018) Mismatch repair deficiency in high-grade meningioma: a rare but recurrent event associated with dramatic immune activation and clinical response to PD‑1. Blockade Jco Precis Oncol 2018:
Gelerstein E, Berger A, Jonas-Kimchi T, Strauss I, Kanner AA, Blumenthal DT et al (2017) Regression of intracranial meningioma following treatment with nivolumab: Case report and review of the literature. J Clin Neurosci 37:51–53
doi: 10.1016/j.jocn.2016.11.011
pubmed: 28089420
Kosugi K, Tamura R, Ohara K, Morimoto Y, Kuranari Y, Oishi Y et al (2019) Immunological and vascular characteristics in cavernous sinus meningioma. J Clin Neurosci 67:198–203
doi: 10.1016/j.jocn.2019.06.003
pubmed: 31213381
Dewan MZ, Galloway AE, Kawashima N, Dewyngaert JK, Babb JS, Formenti SC et al (2009) Fractionated but not single-dose radiotherapy induces an immune-mediated abscopal effect when combined with anti-CTLA‑4 antibody. Clin Cancer Res 15:5379–5388
doi: 10.1158/1078-0432.CCR-09-0265
pubmed: 19706802
pmcid: 2746048
Abuodeh Y, Venkat P, Kim S (2016) Systematic review of case reports on the abscopal effect. Curr Probl Cancer 40:25–37
doi: 10.1016/j.currproblcancer.2015.10.001
pubmed: 26582738
Camphausen K, Moses MA, Menard C, Sproull M, Beecken WD, Folkman J et al (2003) Radiation abscopal antitumor effect is mediated through p53. Cancer Res 63:1990–1993
pubmed: 12702593
Kumaria A, Ingale HA, Macarthur DC (2020) Spontaneous regression of a large skull base meningioma: case report. Br J Neurosurg 34:205–206
doi: 10.1080/02688697.2018.1426728
pubmed: 29334772
Kim BS, Jung TY, Moon KS, Kim IY, Jung S (2022) Meningioma With Partial and Spontaneous Regression of Peritumoral Edema on Long-Term Follow Up. Brain Tumor Res Treat 10:275–278
doi: 10.14791/btrt.2022.0040
pubmed: 36347643
pmcid: 9650118
Kalamarides M, Peyre M (2017) Dramatic Shrinkage with Reduced Vascularization of Large Meningiomas After Cessation of Progestin Treatment. World Neurosurg 101(814):e7–e10
Goncalves AM, Page P, Domigo V, Meder JF, Oppenheim C (2010) Abrupt regression of a meningioma after discontinuation of cyproterone treatment. AJNR Am J Neuroradiol 31:1504–1505
doi: 10.3174/ajnr.A1978
pubmed: 20053802
pmcid: 7966109
Shimizu J, Matsumoto M, Yamazaki E, Yasue M (2008) Spontaneous regression of an asymptomatic meningioma associated with discontinuation of progesterone agonist administration. Neurol Med Chir (tokyo) 48:227–230
doi: 10.2176/nmc.48.227
pubmed: 18497498