Radiotherapy is a vital treatment for many people diagnosed with meningioma, a type of brain tumour that develops from the membranes surrounding the brain and spinal cord. When used alongside surgery – the primary treatment for meningioma patients – it can help control tumour growth, relieve symptoms and, for some, prevent the tumour from returning.
But for some, especially those diagnosed with rare and aggressive high-grade meningiomas or for whom surgery is not an option, radiotherapy is not enough. Tumours can return, grow more quickly and, over time, become resistant to treatment. When this happens, options for patients become increasingly limited.
That is why research led by Dr Juri Na, a senior researcher funded by Brain Tumour Research at our Centre of Excellence at the University of Plymouth, is so important. As part of the Charity’s £2.8 million investment at the Centre, Dr Na is leading innovative research focused on one clear goal - finding ways to make radiotherapy more effective for people with aggressive meningioma.
Her work is built around three connected research themes; understanding why treatments stop working, making radiotherapy more powerful, and speeding up progress by repurposing existing drugs.
Understanding why treatments stop working
One of the biggest challenges in treating aggressive meningioma is radio-resistance. This is when tumour adapt and become less responsive to radiotherapy over time.
Working closely with other experts within the Plymouth Centre of Excellence, Dr Na is investigating how meningiomas change after exposure to radiation. Her research not only looks at the tumour cells themselves, but also at their surrounding environment, including the immune system, to understand how changes may support tumour survival and regrowth.
By uncovering the biological mechanisms that allow meningioma cells to evade the effects of radiotherapy, Dr Na hopes to identify new weaknesses that could be targeted to prevent resistance from developing in the first place.
Dr Na’s work also focuses on how radiotherapy alters chemical signals, known as cytokines, which enable tumour cells and immune cells to communicate. Using world‑class patient‑derived tumour models, the team is recreating radiotherapy treatment conditions in the lab to study how immune cells called macrophages influence treatment response. By doing so, they hope to identify targetable vulnerabilities that could stop aggressive meningiomas becoming resistant to radiotherapy.
Making radiotherapy more powerful
Alongside understanding resistance, Dr Na is also leading research into radiosensitisers – drugs that make tumour cells more sensitive to radiotherapy.
Her team is investigating whether combining radiotherapy with specific drugs could enhance its effectiveness without needing to increase the radiation dose, which is important for reducing side effects and protecting healthy brain tissue.
One area of focus is a group of drugs known as HDAC inhibitors. These drugs are already used to treat some blood cancers and Duchenne muscular dystrophy, and early evidence suggests they may make meningiomas more vulnerable to radiotherapy. Dr Na is also exploring other potential radiosensitisers to identify the most effective combinations for meningioma.
If successful, this approach could improve outcomes for patients by making existing treatments work harder and last longer.
Speeding up progress using existing drugs
For patients facing aggressive meningioma, time matters. That is why a key part of Dr Na’s strategy is to accelerate progress by repurposing drugs that are already clinically approved.
Her team is screening thousands of existing cancer drugs to find those that work particularly well when combined with radiotherapy. Because these drugs already have established safety profiles, any promising combinations could move into clinical trials much more quickly than brand‑new treatments.
This approach has the potential to bring real benefits to patients sooner – a critical aim for a disease where treatment options remain limited.
Dr Na said: “Radiotherapy is a key treatment for meningioma, but we know it does not work equally well for everyone. By understanding why tumours become resistant and identifying ways to enhance radiotherapy without increasing toxicity, we hope to pave the way for more effective and longer‑lasting treatments for patients with aggressive disease.”
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