Meningiomas are the most common primary brain tumour in adults, with an estimated 3,500 people diagnosed each year in the UK. However, treatments have remained unchanged for decades, with surgery and radiotherapy the only available options.
Surgery can be very effective in treating meningioma, but it is not always possible. Operating can also carry significant risks, particularly when tumours are located in difficult-to-reach areas of the brain, return after treatment or behave more aggressively.
At the Brain Tumour Research Centre of Excellence at the University of Plymouth, Dr Leandro Jose de Assis, a senior scientist funded by Brain Tumour Research, is working to develop non surgical treatment approaches that could offer safer and more effective options for meningioma patients.
Meningiomas, like many tumours, need a lot of energy to keep growing. To meet this demand, tumour cells can rewire the way they produce and use energy inside the cell. One of the key proteins involved in this process is called hexokinase 2 (HK2).
Dr de Assis’s research focuses on HK2, examining how meningiomas use the protein and exploring if it could be targeted with new or repurposed drugs.
Because HK2 plays several important roles in the body and is found in healthy cells as well as tumour cells, we cannot directly target it safely, without risking damage to normal tissue. Instead, Dr de Assis is looking at other molecules and mechanisms that interact with HK2 that tumour cells depend on to survive.
The unlikely link between prostate cancer drugs and meningioma
In research funded by Brain Tumour Research, Dr de Assis discovered an unexpected link between HK2 and the androgen receptor – a protein inside cells that acts like a sensor for hormones such as testosterone.
While it is best known for its role in male development, the team found that this receptor is also used by meningioma cells. This discovery opened the door to testing enzalutamide; a hormone therapy that targets the receptor and is already approved for use on the NHS to treat prostate cancer.
In the lab, Dr de Assis and his team found that by combining enzalutamide and hemin (a medicine already approved to treat a rare blood disorder), they could significantly slow the growth of meningioma cells.
They will now explore how this metabolic approach can be combined with other weaknesses in tumour cells with the aim of developing more effective treatments that slow tumour growth and actively destroy tumour cells.
Treating meningioma while protecting healthy cells
While HK2 is involved in energy production in all cells, research shows that in tumour cells it can also act as a kind of scaffold, supporting cancer specific protein interactions that do not occur in healthy tissue.
Dr de Assis is exploring how to disrupt these interactions using specially designed small fragments of proteins called peptides. By breaking these cancer specific protein interactions, Dr de Assis’s goal is to slow tumour growth while minimising damage to healthy brain cells.
When used alongside therapies that target tumour metabolism, this more targeted approach could become a powerful addition to future treatment strategies for aggressive meningioma.
Dr de Assis said: “Our research looks at how brain tumours generate the energy they need to grow and resist treatment. We are developing new ways to cut off this energy supply, aiming to starve tumour cells while protecting healthy ones. Our next steps will focus on testing these approaches and understanding how best to target the pathways tumours rely on to survive.”
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