The effect of TERT promoter mutation on predicting meningioma outcomes: a multi-institutional cohort analysis.

Background: Molecular aberrations have been incorporated into tumour classification guidelines of meningioma. TERT-promoter (TERTp) mutation is associated with worse prognosis and is designated a WHO grade 3 biomarker. However, it remains unclear whether TERTp mutation is context-dependent, with other co-occurring genetic alterations potentially driving its association with prognosis.

Nuances in visual rehabilitation after pituitary surgery.

Background: Patients with pituitary lesions often present with visual deficits attributable to mass effect along the optic pathway or on the cranial nerves controlling extraocular muscles. While symptoms often improve after treatment, persistent symptoms negatively impact quality of life.

Methods: We reviewed the literature on emerging concepts in visual monitoring and recovery during and after pituitary surgery.

Ki-67 in meningioma: distribution and implications.

Objective: Ki-67 is a widely used marker of proliferation in meningiomas, influencing prognostic assessment and treatment decisions, including adjuvant radiation therapy. However, it is increasingly appreciated that some meningiomas are enriched with immune infiltration, which may confound Ki-67 interpretation as both immune and tumor cells exhibit proliferative potential. The authors aimed to dissect the cellular source and distribution of Ki-67 within the meningioma microenvironment and explore their clinical, genomic, and biological associations.

Distribution of copy number alterations and impact of chromosome arm call thresholds for meningioma.

Chromosome-arm copy number alterations (CNAs) are an important component of cancer molecular classifiers. CNAs are often translated into binary chromosome arm calls (arm gain/loss) using an arm call threshold before integration into classification schemes. However, substantial variability exists in thresholds used to define arm calls from CNA data.

Mesothelin is a surface antigen present on human meningioma and can be effectively targeted by CAR T-cells.

Background: Meningioma is the most common primary CNS tumor, with high-grade cases exhibiting aggressive behavior, frequent recurrence, and poor prognosis. Currently, no systemic therapies are approved for recurrent or malignant meningiomas. Chimeric antigen receptor (CAR) T-cell therapy has shown efficacy in hematologic malignancies and promise for solid tumors but its use for meningiomas has been underexplored.

Clinical, molecular and radiological predictors of prognosis in newly diagnosed astrocytoma, IDH-mutant, WHO grade 4.

Background: Astrocytoma, isocitrate dehydrogenase-mutant, WHO grade 4 (Astro4), is a new tumor type in the 2021 WHO classification of central nervous system tumors that has been poorly characterized in the literature. This study evaluates predictors of prognosis in a large cohort of newly diagnosed Astro4.

Methods: We retrospectively identified 128 consecutive adult patients who presented with an initial diagnosis of Astro4 at Dana-Farber Cancer Institute and Massachusetts General Hospital between 2010 and 2021.

Epstein-Barr virus-associated smooth muscle tumor partially occluding the superior sagittal sinus: illustrative case.

Background: Venous sinus-occlusive mass lesions are infrequent and commonly include meningiomas, with Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) being much less common.

Observations: The authors present a case report of a venous sinus-occlusive EBV-SMT in an adolescent immunosuppressed male after liver transplantation.

Lessons: The case highlights the importance of considering blood flow dynamics and the use of advanced imaging modalities including incident dark field microcirculation microscopy and indocyanine green video angiography when managing venous sinus-occlusive mass lesions.

Interpretation and Strategy to Resolve Neuromonitoring Changes Associated With Brain Sag.

Background And Objectives: Intraoperative neuromonitoring (IONM) aides in safe maximal resection of brain tumors in eloquent areas. During the resection of large or deep-seated tumors, shifts in the peri-resectional parenchyma and cortical surface relative to cranial electrodes, or brain sag, can cause false-positive loss of sensorimotor signals. We describe patterns of electrophysiological changes associated with brain sag and a facile technique to rapidly resolve these changes intraoperatively by saline infusion.

Immune atlas of pituitary neuroendocrine tumors highlights endocrine-driven immune signature and therapeutic implication.

Whether the tumor microenvironment is shaped by endocrine hormone secretion, as well as its cellular heterogeneity and therapeutic implications in pituitary neuroendocrine tumors (pitNETs), remains poorly understood. We demonstrate that pitNETs exhibit a sparse immune infiltration. Mass cytometry of 97,418 immune cells from 56 pitNETs establishes a high-resolution atlas, with macrophages and T cells comprising the predominant populations.

A single-cell atlas of Schwannoma across genetic backgrounds and anatomic locations.

Background: Schwannomas are nerve sheath tumors arising at cranial and peripheral nerves, either sporadically or in patients with a schwannomatosis-predisposition syndrome. There is limited understanding of the transcriptional heterogeneity of schwannomas across genetic backgrounds and anatomic locations.

Methods: Here, we prospectively profile by single-cell full-length transcriptomics tumors from 22 patients with NF2-related schwannomatosis, non-NF2-related schwannomatosis, and sporadic schwannomas, resected from cranial and peripheral nerves.

PD-L1, Tumor Mutational Burden, and Outcomes in NSCLC With Brain Metastases: A Brief Report.

Introduction: Patients with NSCLC and brain metastases have a poor prognosis. Combining brain-directed radiation therapy (RT) with immune checkpoint inhibitors (ICIs) may be synergistic. Nevertheless, predictors of response and toxicity are lacking.

Ivosidenib for the treatment of IDH1-mutant glioma, grades 2-4: Tolerability, predictors of response, and outcomes.

Background: Mutant isocitrate dehydrogenase (IDHm) inhibitors represent a novel targeted approach for treating IDHm glioma patients, yet their optimal use in clinical practice outside of clinical trials remains undefined. This study describes the real-world utilization of the mutant IDH1 inhibitor (IDHi), ivosidenib, in patients with IDHm glioma.

Methods: We retrospectively reviewed clinical and radiographic data from patients with IDHm glioma treated with ivosidenib monotherapy from 2020 to 2024 at the Dana-Farber Cancer Institute and Massachusetts General Hospital.

Motor mapping-guided resection of a brainstem recurrent pilocytic astrocytoma.

Brainstem tumors are bounded by a compact topography of eloquent tracts, cranial nerves, and nuclei. Reliable intraoperative neuromonitoring aids microneurosurgical technique to optimize safe resection. The authors present a case of motor mapping-guided resection of a recurrent brainstem pilocytic astrocytoma.