Recent advances in managing/understanding meningioma

Abstract

Meningiomas are the most common adult primary intracranial tumor. Despite their higher incidence, there have not—until recently—been as many advances in understanding and managing meningiomas. Thus far, two broad classes of meningiomas have emerged on the basis of their mutational profile: those driven by neurofibromatosis 2 (NF2) inactivation and those with non-NF2 driver gene alterations, such as mammalian target of rapamycin and Hedgehog, Wingless/b-catenin, Notch, transforming growth factor-b receptor, mitogen-activated protein kinase, and phospholipase C pathway alterations. In addition to improvements in molecular diagnostics, advances in imaging are being studied to better predict tumor behavior, stratify risk, and potentially monitor for disease response. Management consists primarily of surgery and radiation therapy and there has been limited success from medical therapies, although novel targeted agents are now in clinical trials. Advances in imaging and understanding of the genetic makeup of meningiomas demonstrate the huge potential in revolutionizing the classification, diagnosis, management, and prognosis of meningiomas..

Nonmalignant and malignant meningioma incidence and survival in the elderly, 2005–2015, using the Central Brain Tumor Registry of the United States

“…21 Recent research in glioblastoma and meningioma has highlighted the importance of epigenetic alterations such as DNA methylation patterns in tumorigenesis, which could explain the increased incidence in elderly populations for these 2 different tumor types. [22][23][24][25][26][27][28] It will be necessary to conduct further research to explore this hypothesis and other alternative hypotheses relating to non-epigenetic molecular differences, environmental factors, and other potential contributors. In addition to increased incidence with age, we also identified a significant female predominance in nonmalignant meningioma for every 5-year age group studied and a non-significant predominance for malignant meningioma (Fig.…”

Cerebrospinal Fluid MicroRNA Signatures as Diagnostic Biomarkers in Brain Tumors

“…Compared to a good prognosis of grade I, atypical meningiomas grow and progress more rapidly and represent about 15%. Meningiomas grade III are rarer and they occur around 2% and show the most aggressive behaviour [5,6,7]. Brain metastases are also one of the most frequently occurring brain malignancies with poor overall survival [8].…”

Serum and cerebrospinal fluid Neudesin concentration and Neudesin Quotient as potential circulating biomarkers of a primary brain tumor

“…The molecular machinery of meningiomas, which are the most common intracranial tumors in adults, has still not been fully understood [22]. The available literature on circulating meningioma biomarkers is extremely scarce [11, 22–26]. Interestingly, the histopathological grade of these tumors does not always correlate with their progression/recurrence [22], therefore our findings may help in the understanding of meningioma biology.…”

“…The reason behind such low levels of Neudesin in meningioma patients is unclear. The molecular machinery of meningiomas, which are the most common intracranial tumors in adults, has still not been fully understood [22]. The available literature on circulating meningioma biomarkers is extremely scarce [11, 22–26].…”