Investigating Meningioma Recurrence with the Comprehensive Resources of the Nurses’ Health Study

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Although most meningiomas are classified as benign, substantial growth of these tumors can cause major neurological damage and cause substantial disability.

Ionizing radiation and hereditary syndromes are established risk factors for meningioma, and while hormone treatments have been classified as an established risk factor, data are sparse and inconsistent. Moreover, few prognostic markers exist to guide decision making for the management of meningioma patients.

Our understanding of why meningiomas occur and the likely outcomes (such as tumors recurring after the original surgery) could be greatly enhanced by establishing a comprehensive resource linking clinical information with tumor samples. The Nurses’ Health Study (NHS) provides a unique opportunity. The first cohort was initiated in 1976 at the Channing Lab at Brigham and Women’s Hospital with the enrollment of 121,700 female, U.S.-registered nurses between the ages of 30 and 55. This became known as NHS I. This cohort has been followed carefully now for 35 years and detailed information has accrued on factors relevant to women’s health, exposure information and meningioma incidence and outcome. In 1989, an additional 116,678 women aged 25–42 were enrolled in the NHS II. The prospective accumulation of information and the length of follow-up are fundamental advantages of these cohorts.

Dr. Santagata’s project will examine both Nurses’ studies for insights into meningiomas—both causes and outcomes. More than 600 participants in the two studies reported being diagnosed with meningioma, providing a wealth of information to review. Tissue from these cases, however, has not been collected. Along with Dominique Michaud at Brown University, Dr. Santagata’s team will build a tissue resource from the NHS meningioma samples that could provide vast opportunities for epidemiologic and biomarker studies.