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Endocrine Manipulation of Meningiomas with Medroxyprogesterone Acetate

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Neuro-Oncology

Part of the book series: Developments in Oncology ((DION,volume 66))

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Abstract

Medroxyprogesterone acetate (MPA) acted as a competitive binder to progesterone receptors (PR) of meningioma cytosols after in-vivo administration (PRmean =15.6 fmol/mg protein 338.3 fmol/g tumor, n = 15), in comparison to 54.9 fmol/mg protein (2813 fmol/g tumor) in our untreated meningioma series (n = 58). In cases of two-stage resection of meningiomas MPA significantly decreased cytoplasmic PR activity.

In monolayer tissue culture of primary meningioma cells (n = 37) in vivo MPA-pretreated meningiomas showed sufficient growth in 38% whereas untreated meningiomas grew well in 50%. MPA-induced inhibition or delay of growth was observed in 35%.

Furthermore the effect of MPA on growth fractions of ex vivo meningiomas was demonstrated by use of the Ki-67 monoclonal antibody in three cases of meningiomas operated on in two stages and in meningioma specimens from a group of 21 patients operated on in one single stage after MPA therapy. In the three cases of two-stage operation of the tumors, the percentage of Ki-67-positive cells in meningioma tissue was lower by a factor of 6, 5, and 3, respectively, after MPA therapy. In meningioma specimens from patients receiving no MPA therapy (n = 11), Ki-67-positive cells were present in 1.02 ± 0.48%; in samples from MPA-treated tumors the percentage of Ki-67-positive cells was 0.41 ± 0.40. Although immunocytochemical evidence of the presence of genuine PR in meningiomas has been established and MPA significantly reduces PR activity there is no obvious correlation between PR activity and the potential suppression of the tumor growth fraction.

Recent results indicate that the effects of MPA may be mediated by a decreasing content of epidermal growth factor receptors (EGF-R) in meningiomas resulting in a decrease of tumor growth. This decrease of EGF-R content offers an explanation for the diminution of meningioma growth fractions after MPA therapy.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Bern, Inselspital, Freiburgstrasse, CH-3010, Bern, Switzerland

    Thomas-Marc Markwalder M.D.

  2. Institute of Pathology, University of Bern, Inselspital, Freiburgstrasse, CH-3010, Bern, Switzerland

    Ernst R. Waelti Ph.D.

Authors
  1. Thomas-Marc Markwalder M.D.
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  2. Ernst R. Waelti Ph.D.
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Editor information

Editors and Affiliations

  1. University of Pavia, Pavia, Italy

    P. Paoletti (Professor of Neurosurgery), G. Butti (Assistant Professor of Neurosurgery) & S. Pezzotta (Associated Professor of Neurosurgery) (Professor of Neurosurgery),  (Assistant Professor of Neurosurgery) &  (Associated Professor of Neurosurgery)

  2. Department of Neurosurgery, University of Tokyo, Tokyo, Japan

    K. Takakura (Professor and Chairman) (Professor and Chairman)

  3. Division of Stroke and Trauma, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, U.S.A.

    M. D. Walker (Director) (Director)

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© 1991 Springer Science+Business Media Dordrecht

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Markwalder, TM., Waelti, E.R. (1991). Endocrine Manipulation of Meningiomas with Medroxyprogesterone Acetate. In: Paoletti, P., Takakura, K., Walker, M.D., Butti, G., Pezzotta, S. (eds) Neuro-Oncology. Developments in Oncology, vol 66. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3152-0_50

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  • DOI: https://doi.org/10.1007/978-94-011-3152-0_50

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5390-7

  • Online ISBN: 978-94-011-3152-0

  • eBook Packages: Springer Book Archive

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