LB-100 enhanced therapeutic efficiency of radiation in vivo. (A) Mice were implanted with 1 × 105 IOMM-LEE cells on the right skull base. Five days after implantation, mice with established tumors on bioluminescence images (BLI) (>5 × 104 photons/s/sr/cm2) were randomized into 4 treatment groups – control, LB-100, RT and combination. Treatments (LB-100 - 1.5 mg/kg and/or RT - 2Gy) were given on day 5, 7, 9 and 12. BLI was obtained on day 11 and 18. (B) Representative BLI images obtained on day 11 and 18 from each treatment group. (C) Quantification of BLI data obtained on day 18 after tumor implantation. There was a trend towards decrease in tumor burden in the combination group compared to RT alone, but it was not statistically significant (p=0.15, student t-test comparing between RT and combination group). (D) Kaplan–Meier survival curves of different treatment groups and compared using the log-rank test. LB-100 + RT combination therapy showed survival benefit compared to RT alone. *P < .05 and ***P < .001. (E) Representative images of gross examination of mice cranium at the survival end point demonstrated expected skull base location of the implanted tumors. (F) Representative images of Hematoxylin and eosin (H&E) coronal section of a mouse skull showing meningioma situated between the brain and skull base. (G) Representative H&E image of implanted tumor showing histologic features consistent with aggressive meningiomas. Tumors are highly cellular with large pleomorphic nuclei, with evidence of brain invasion. Original magnification × 20.