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Malignant meningiomas
Daniel M Fountain1, Adam M H Young1, Thomas Santarius1
1Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
Abstract:
Malignant meningiomas are WHO Grade III meningiomas representing 1% of all meningiomas. They are comprised of three histologic types: anaplastic, rhabdoid, and papillary. They can arise de novo or as a result of biologic progression of meningiomas of lower histologic grades. The overall survival of patients with WHO grade III meningiomas is 2-3 years. Surgery is the main treatment, while radiotherapy is thought to slow tumor growth. Multiple trials have been attempted on chemotherapeutic agents, hormonal therapies, small molecule and anti-angiogenic agents without robust evidence of efficacy. The rarity of these tumors is the main reason for our patchy understanding of the natural history and lack of effective treatment options. There is an urgent need to develop alternative therapies given the significantly increased risk of complication and co-mordibity associated with repeated surgeries in this population.
Insights
Malignant meningiomas (WHO Grade III) are rare, aggressive tumors with a poor prognosis. Developing novel therapies is crucial due to limited treatment options and the risks associated with surgery.
Area of Science:
- Neuro-oncology
- Pathology
- Oncology
Background:
- Malignant meningiomas, classified as WHO Grade III, constitute 1% of all meningiomas.
- These tumors can develop initially or progress from lower-grade meningiomas.
- Histologic subtypes include anaplastic, rhabdoid, and papillary types.
Purpose of the Study:
- To highlight the challenges in understanding and treating malignant meningiomas.
- To emphasize the need for novel therapeutic strategies.
Main Methods:
- Review of existing literature on malignant meningiomas.
- Analysis of treatment outcomes and challenges.
Main Results:
- Malignant meningiomas have a poor prognosis with a 2-3 year overall survival rate.
- Surgery is the primary treatment; radiotherapy may slow growth.
- Current chemotherapeutic and targeted agent trials lack robust efficacy data.
Conclusions:
- The rarity of these tumors hinders research into their natural history and effective treatments.
- Alternative therapies are urgently needed due to the high risk of complications from repeated surgeries.
