Andromede study - a new impulse

Meningiomas are the most frequent intracranial tumors and are developed at the expense of the meninges, which constitute the brain envelopes. These tumors preferentially affect women, can evolve quickly during pregnancy, and have progesterone receptors on their surface. It is only recently that it was able to demonstrate that the taking of synthetic progestins (drugs derived from progesterone) at high dose such as Androcur (cyproterone acetate), but also lutenyl (numegestrol acetate) and luteran (chlormadinone acetate), was associated with a higher incidence of meningiomes, and that the treatment was extended. Since 2007, many series had brought in the increase in the risk of developing meningiomas during prolonged use of high doses of progesterone acetate. A large -scale epidemiological study made it possible to highlight a very significant increase in the risk of meningioma in women treated by Androcur, Luteran and Lutenyl for long periods of high doses.

Suite à ces études, la prescription d’ Androcur a fortement diminué, passant de 55 000 personnes en août 2018 à 7 900 personnes fin 2021.
Pour les personnes dont l’état de santé nécessite la prise de progestatifs de synthèse, se pose néanmoins toujours la question du risque de survenue des méningiomes. Afin de pouvoir mieux comprendre pourquoi certaines femmes ont développé des méningiomes sous progestatifs et pas d’autres, et pouvoir éventuellement anticiper le risque de survenue chez des nouvelles patientes, il nous faudrait pouvoir découvrir un facteur de susceptibilité génétique favorisant la survenue de méningiomes sous progestatifs.

We have reasons to think that this factor exists, especially because we have observed that cases of meningiomas under Androcur were overrepresented in certain families, and cases in real twins have also been described. The genome of each individual is characterized by a set of elements (a few million) slightly different from one individual to another: we speak of polymorphic variants. Current molecular biology techniques make it possible to highlight links between these genetic polymorphisms and the risky to develop this or that disease. These are association studies (in English Genome Wide Association Study = GWAS).

It is this strategy that we decided to implement in the context of the Andromeda study by analyzing these genetic variants (SNP = Single Nucleotide Polymorphisms) distributed over the entire genome and determining if certain variants are actually associated with the risk of developing a meningioma under Androcur, Luteran or Lutenyl. This would ultimately make it possible to identify people more at risk of meningioma under Androcur, Luteran or Lutenyl and to better understand the mechanisms leading to the development of a meningioma under Androcur, Luteran or Lentenyl.

Nous avons déjà obtenu la participation de plus de 120 patientes pour cette étude. Néanmoins, pour pouvoir la mener à bien, il nous faudrait pouvoir obtenir au moins 200 participantes. Vous êtes concernées si :

- You have followed a treatment by Androcur, Luteran or Lutenyl for more than 6 months

- You present on your brain MRI:

• Or several meningiomas (very likely genetic susceptibility),
• soit un seul méningiome (possible susceptibilité génétique),
• Or no meningiomas (control group, no genetic susceptibility).

Nous avons donc décidé de donner une nouvelle impulsion à l’étude Andromede, avec une nouvelle équipe de médecins référents, que vous pouvez contacter pour proposer votre participation éventuelle dès à présent pour toute question sur cette étude :

Dr. Matthew Peyre, MCU-PH, MD, PHD

Neurosurgery service, Pitié-Salpêtrière Hospital

47-83 BVD de l'Hopital, 75013 Paris

Such : 01-42-16-31-03

Email : matthieu.peyre@aphp.fr

Dr Yohan Ducos, MSC

Genetics team and brain tumor development

Brain Institute

47-83 BVD from the hospital, 75013 Paris

Such : 01 57 27 40 73

Email : yohan.ducos@icm-institte.org

This study, carried out in collaboration with the neurosurgery services of Hospitals Sainte-Anne and Lariboisière in Paris, could have a positive impact for all patients likely to receive treatment with progestins, or even all women if it makes it possible to define a risk factor for the occurrence of meningiomas.

C’est très simple : pas besoin de se déplacer, tout se fait par courrier, avec envoi d’un kit de prélèvement d’ADN salivaire, avec une enveloppe pré-affranchie afin que vous puissiez renvoyer un prélèvement de salive en vue de l’étude.

Thank you in advance to all the patients who will participate!