Understanding druggable drivers of meningioma tumorigenesis

项目总结 中枢神经系统的脑膜衬里对神经元发育和动态平衡至关重要。 然而，脑膜肿瘤占大多数的原发颅内癌症。脑膜瘤是 绝大多数在老年人、女性和非裔美国人患者中被诊断出来，所有这些都是 在临床试验中代表性不足。因此，脑膜瘤尚无有效的药物治疗方法。 病人。新的治疗方法由于对脑膜瘤生物学的有限了解和 缺乏可用于临床前脑膜瘤研究的易处理模型。为了解决这些问题，我们执行了 综合随访资料对565例脑膜瘤患者的多平台分子图谱分析 发现脑膜瘤由3个表观遗传学亚群组成，临床结果各不相同。此外， 我们最近开发了新的脑器官移植模型和患者来源的异种移植模型，适用于每一亚组 脑膜瘤。我们在本申请中提供的初步数据揭示了收敛的遗传机制 在临床结果最差的脑膜瘤亚组中，CDK6水平的细胞周期失活。 我们的中心假设是CDK6是脑膜瘤生长所必需的，而临床上的CDK4/6抑制剂将 在临床前脑膜瘤模型中显示活动。为了验证这一假设，我们将定义疗效和生物标记物 脑膜瘤对CDK4/6抑制剂的反应，确定CDK6的分子机制 脑膜瘤中的失活，并确定减轻脑膜瘤对CDK4/6阻断的抵抗力的途径。 我们的计划将整合人类样本、脑膜瘤发生的器官模型和未被充分研究的 具有CRISPR干扰和药理学的患者来源的异种移植。这种方法是基于这样一个前提 改善脑膜瘤患者的治疗取决于我们识别和定位关键分子的能力 驱动脑膜瘤细胞增殖的机制。我们对脑膜瘤是如何发展的知之甚少， 几乎没有关于如何阻止脑膜瘤生长的分子机制。虽然 这项提议的短期目标是广泛地提高我们对脑膜瘤细胞增殖的理解 这项研究的长期目标是充分了解这一过程，以开发有针对性的治疗方法。 将改善脑膜瘤患者的治疗和结果的策略。因此，这项工作不仅将 解释脑膜瘤是如何生长的，但也将阐明可用药的机制并建立临床前研究 基金会支持脑膜瘤患者的新临床试验。

Project summary The meningeal lining of the central nervous system is critical for neuronal development and homeostasis. However, meningeal tumors account for the majority of primary intracranial cancers. Meningiomas are overwhelmingly diagnosed in older adults, women, and African American patients, all of which are underrepresented in clinical trials. Thus, there are no effective pharmacologic treatments for meningioma patients. New therapies have been further encumbered by limited understanding of meningioma biology and a lack of tractable models for preclinical meningioma investigation. To address these problems, we performed multiplatform molecular profiling on 565 human meningiomas from patients with comprehensive follow-up data to discover that meningioma is comprised of 3 epigenetic subgroups with distinct clinical outcomes. Moreover, we recently developed novel cerebral organoid and patient derived xenograft models for each subgroup of meningiomas. Our preliminary data presented in this application reveal convergent genetic mechanisms misactivating the cell cycle at the level of CDK6 in the subgroup of meningiomas with the worst clinical outcomes. Our central hypothesis is that CDK6 is required for meningioma growth, and that clinical CDK4/6 inhibitors will show activity in preclinical meningioma models. To test this hypothesis, we will define the efficacy and biomarkers of response to CDK4/6 inhibitors in meningioma, define the molecular mechanisms underlying CDK6 misactivation in meningiomas, and identify pathways mitigating resistance to CDK4/6 blockade in meningioma. Our proposal will integrate human samples, organoid models of meningioma tumorigenesis, and understudied patient derived xenografts with CRISPR interference and pharmacology. This approach is based on the premise that improving treatments for meningioma patients depends on our ability to identify and target key molecular mechanisms driving meningioma cell proliferation. We know surprisingly little about how meningiomas develop, and almost nothing about how to block the molecular mechanisms underlying meningioma growth. Though the short-term objective of this proposal is to broadly improve our understanding of meningioma cell proliferation, a long-term goal of this research is to understand this process well enough to develop targeted therapeutic strategies that will improve treatments and outcomes for meningioma patients. Thus, this work will not only explain how meningiomas grow, but will also elucidate druggable mechanisms and establish preclinical foundation to support new clinical trials for meningioma patients.