Innovative treatments for meningiomas.

Area of Science:

• Neuro-oncology
• Molecular Biology
• Genetics

Background:

• Multi-recurrent high-grade meningiomas pose significant challenges in neuro-oncology, often resisting conventional treatments like surgery and radiation.
• Recent years have seen major progress in understanding meningioma development, identifying key mutations, signaling pathways (e.g., Pi3K-Akt-mTOR, MAP kinase), and methylation patterns.

Purpose of the Study:

• To review current and emerging therapeutic strategies for high-grade meningiomas.
• To highlight the potential of novel molecular targets and treatment modalities in managing aggressive and recurrent tumors.

Main Methods:

• Review of recent scientific literature on meningioma tumorigenesis, molecular targets, and clinical trials.
• Analysis of current therapeutic approaches including targeted therapies, radiation, and immunotherapy.

Main Results:

• Anti-VEGF and mTOR inhibitors are currently active in aggressive meningiomas.
• Targeted therapies against Pi3K-Akt-mTOR, MAP kinase, and cell cycle pathways are under investigation.
• NF2 mutations remain a key challenge; FAK and Hippo pathway inhibitors show promise.
• Immunotherapy, particularly PD-1 inhibitors combined with radiation, is a promising avenue.

Conclusions:

• Despite advances, effective treatment for multi-recurrent high-grade meningiomas remains a significant unmet need.
• Multiple promising therapeutic targets and innovative strategies are emerging, offering hope for improved patient outcomes.