Integrated Molecular-Morphologic Meningioma Classification: A Multicenter Retrospective Analysis, Retrospectively and...

Area of Science:

• Neuro-oncology
• Genomics
• Tumor Biology

Background:

• Meningiomas are common primary brain tumors with variable patient outcomes.
• Current risk stratification relies on WHO grading, with limited molecular biomarkers for low- and intermediate-risk tumors.
• Accurate prediction of meningioma progression is crucial for patient management.

Purpose of the Study:

• To develop and validate a molecularly informed risk stratification score for meningiomas.
• To improve the prediction accuracy of tumor progression and recurrence.
• To provide a more precise stratification tool, particularly for WHO grade 1 and 2 meningiomas.

Main Methods:

• Analysis of DNA methylation, copy-number variations (CNVs), and mutation data from 3,031 meningiomas.
• Development of CNV- and methylation-based subgroupings.
• Creation and validation of an integrated molecular-morphologic score across multiple patient cohorts.

Main Results:

• CNV and methylation subgroupings improved risk prediction accuracy over WHO classification.
• The integrated molecular-morphologic score achieved a higher c-index (0.744) compared to WHO grading (0.699).
• The integrated score demonstrated superior accuracy in all validation cohorts and improved stratification at the WHO grade 1/2 interface.

Conclusions:

• An integrated score combining histologic and molecular data significantly enhances meningioma stratification precision.
• This molecular-morphologic score offers robust outcome prediction for clinical decision-making.
• Implementation of this score can guide treatment strategies for meningioma patients.