• Philip D Tatman, Tadeusz H Wroblewski, Anthony R Fringuello, Samuel R Scherer, William B Foreman, Denise M Damek, Kevin O Lillehei, Randy L Jensen, A Samy Youssef, D Ryan Ormond, and Michael W Graner.
• Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Medical Scientist Training Program, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Department of Pharmacology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
• World Neurosurg. 2022 Jun 1; 162: e99-e119.

ObjectiveMeningiomas are a common primary central nervous system tumor that lack a U.S. Food and Drug Administration-approved pharmacotherapy. Approximately 20%-35% of meningiomas are classified as higher grade with poor outcome, whereas patients with lower-grade meningiomas are known to have long-term neurologic deficits and reduced overall survival. Recent efforts to understand the epigenetic landscape of meningiomas have highlighted the importance of DNA methylation for predicting tumor outcomes and prognosis; therefore, inhibition of these pathways may present a viable therapy for these tumors.MethodsIn this study, we perform dose-response curves of decitabine, a DNA methyltransferase inhibitor, on patient-cultured tumors and meningioma cell lines.ResultsThirty total samples were evaluated, including 24 patient-cultured tumors and 6 established meningioma cell lines. Meningiomas were found to have a significant reduction in cell viability after decitabine treatment in a dose dependent manner. The effect was primarily driven by 11 of the 30 tumors in our cohort, or 36.7%. Decitabine significantly reduced cell viability across all grades, tumors from different sexes, recurrent and primary tumors, as well as tumors without a history of previous radiation. Surprisingly, our single radiation-induced tumor did demonstrate greater viability after decitabine treatment.ConclusionsOur work has identified a potential drug candidate in decitabine for the treatment of meningiomas regardless of clinical subgroup. These data require further evaluation in preclinical models, and the conclusions based on clinical subgroups need to be evaluated in a larger cohort to achieve appropriate statistical power.Copyright © 2022 Elsevier Inc. All rights reserved.

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