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.
Following these studies, the prescription of Androcur has decreased sharply, going from 55,000 people in August 2018 to 7,900 people at the end of 2021.
For people whose state of health requires the taking of summary progestins, nevertheless still raises the question of the risk of the occurrence of meningiomas. In order to be able to better understand why some women have developed meningiomas under progestin and not others, and possibly be able to anticipate the risk of occurrence in new patients, we should be able to discover a factor of genetic susceptibility promoting the occurrence of meningiomas under progestin .
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.
We have already obtained the participation of more than 120 patients for this study. However, to be able to carry it out, we should be able to obtain at least 200 participants. You are concerned if:
- 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),
- or a single meningioma (possible susceptibility ),
- Or no meningiomas (control group, no genetic susceptibility).
We have therefore decided to give a new impetus to the Andromede study, with a new team of referent doctors, which you can contact to offer your possible participation now for any question on this study:
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.
It is very simple: no need to move, everything is done by mail, with sending a salivary DNA sampling kit, with a pre-affranchia envelope so that you can return a saliva sample for the study.
Thank you in advance to all the patients who will participate!
