Evidence map›Paper›PMID 39886924›Full record

ArticleJournal of the National Cancer Institute2025

NF2 loss-of-function and hypoxia drive radiation resistance in grade 2 meningiomas.

Bhuvic Patel, Sangami Pugazenthi, Collin W English, Vijay Nitturi, Shree S Pari, Tatenda Mahlokozera, William A Leidig, Hsiang-Chih Lu, Alicia Yang, Kaleigh Roberts and 12 more

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Combined SSTR2-targeted Analogue withFrontiers in oncology · 2026
    Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Bhuvic PatelTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0001-8062-7310
Sangami PugazenthiTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0002-5179-5232
Collin W EnglishDepartment of Neurological Surgery, Baylor School of Medicine, Houston, TX 77030, United States.ORCID 0000-0003-3730-2793
Vijay NitturiDepartment of Neurological Surgery, Baylor School of Medicine, Houston, TX 77030, United States.ORCID 0000-0002-8310-3077
Shree S PariTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0001-7915-7606
Tatenda MahlokozeraTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
William A LeidigTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
Hsiang-Chih LuDepartment of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0002-4927-4577
Alicia YangTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
Kaleigh RobertsDepartment of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, United States.
Patrick DeSouzaTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0003-3600-4452
Kyle P McGeehanTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
Diane D MaoTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
Namita SinhaDepartment of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, United States.
Joseph E IppolitoDepartment of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States.
Sonika DahiyaDepartment of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0002-5585-0964
Allegra PettiDepartment of Neurological Surgery, Massachusetts General Hospital, Boston, MA, United States.
Hiroko YanoTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.
Tiemo J KlischJan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, United States.
Akdes S HarmanciCenter for Cancer Neuroscience, Baylor College of Medicine, Houston, TX, United States.
Akash J PatelJan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX 77030, United States.
Albert H KimTaylor Department of Neurological Surgery, Washington University School of Medicine, St Louis, MO 63110, United States.ORCID 0000-0002-1751-8493

Funding

2019-2020 Neurosurgery Research and Education Fund2023 American Brain Tumor Association Jack & Fay Netchin Medical Student Summer2023 NREF Medical Student Summer ResearchAcademy of Neurological Surgeons Research Fellowship GrantAlvin J. Siteman Cancer Research Fund GF0010215an and Dan Duncan Neurological Research InstituteCancer Prevention and Research Institute of TexasChristopher Davidson and Knight Family FundDuesenberg Research FundNeurological Research InstituteWashington University School of Medicine Dean's Medical Student Research
6 · The paper itself

Abstract

backgroundWorld Health Organization Grade 2 meningiomas (G2Ms) often recur and resist therapies. Grade 2 meningiomas with histopathological necrosis have been associated with worse local control (LC) after radiation therapy, but the drivers and biomarkers of radiation resistance in G2Ms remain unknown.

methodsWe performed genetic sequencing and histopathological analysis of 113 G2Ms and investigated the role of genetic and microenvironmental factors on clonogenic survival after ionizing radiation. We performed transcriptional profiling of our in vitro model and 18 human G2M tumors by bulk RNA sequencing as well as 8 G2Ms by single nuclei RNA sequencing.

resultsNF2 loss-of-function (LOF) mutations were associated with necrosis in G2Ms (P = .0127). Tumors with NF2 mutation and necrosis had worse post-radiation LC compared to NF2 wildtype tumors without necrosis (P = .035). Under hypoxic conditions, NF2 knockdown increased radiation resistance in vitro (P < .001). Bulk RNA sequencing revealed NF2- and hypoxia-specific changes and a 50-gene set signature specific to radiation-resistant, NF2 knockdown, and hypoxic cells, which distinguished NF2 mutant/necrotic patient G2Ms by unsupervised clustering. Enrichment analysis revealed downregulation of apoptosis pathway genes and upregulation of proliferation-associated genes and genes normally downregulated after UV radiation exposure in NF2-mutant/necrotic tumor cells, which were validated with functional assays.

conclusionsNF2 LOF in the setting of hypoxia confers radiation resistance through transcriptional programs that reduce apoptosis and promote proliferation. These pathways may identify tumors resistant to radiation and represent therapeutic targets that in the future could improve LC in patients with radiation resistant G2Ms.

Indexed as

Loss of Function MutationMeningeal NeoplasmsMeningiomaNeurofibromin 2Radiation ToleranceAdultAgedCell Line, TumorFemaleGene Expression Regulation, NeoplasticHumansMaleMiddle AgedNecrosisNeoplasm GradingNeurofibromin 2NF2 protein, human

Identifiers

PMID39886924
PMCPMC12145909

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.