Newswise — Winner of the Young Neurosurgeons Medical Student Abstract Award, Yuping (Derek) Li, presented his research, Systemic and Local Immunosuppression in Patients with High-Grade Meningiomas, during the 2018 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting.
Despite aggressive treatment with surgery and radiation, atypical and anaplastic meningiomas have a high rate of recurrence with limited options for systemic treatment. Immunotherapy targeting immune checkpoints, such as PD-L1, has demonstrated significant success in controlling numerous malignancies. In this study, researchers investigated the extent of systemic and local immunosuppression in meningiomas to assess the potential benefit of immune checkpoint inhibitors for the treatment of high-grade meningiomas.
Peripheral blood was collected from patients undergoing resection of their meningiomas. Immunosuppressive monocytes, myeloid-derived suppressor cells (MDSCs) and regulatory T-cells were quantified through flow cytometry. Tissue sections from the same patients were assessed for PD-L1 expression via immunohistochemistry.
Patients with grade III meningiomas demonstrated increased peripheral monocyte PD-L1, compared to patients with grade I/II meningiomas and healthy controls, with an average 2.1-fold increase. Compared to healthy controls, mean MDSC abundance was increased 2.9-fold in grade I, 6.3-fold in grade II and 6.8-fold in grade III meningioma patients. Patients with grade II/III meningiomas had significantly increased MDSC abundance compared to patients with grade I meningiomas.
Patients with meningiomas exhibit signs of peripheral immunosuppression, including increased PD-L1 on myeloid cells and elevated MDSC abundance proportional to tumor grade. Additionally, intratumoral PD-L1 expression was proportional to tumor grade. These results suggest a role for immune checkpoint inhibitors targeting the PD-L1/PD-1 pathway in combination with standard therapies for the treatment of high-grade meningiomas.
Author Block: Dorina Veliceasa, PhD; Jason Lamano; Jonathan Lamano; Gurvinder Kaur, MD; Joseph DiDomenico; Daniel Oyon; Benjamin Smith; Orin Bloch, MD
Disclosure: The author reported no conflicts of interest.
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Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 11,000 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves.
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