Emerging targeted therapies in meningiomas

Area of Science:

• Neuro-oncology
• Molecular Medicine
• Clinical Therapeutics

Background:

• High-grade meningiomas (grades 2 and 3) exhibit high recurrence rates.
• Limited treatment options exist for patients with recurrent or refractory meningioma after surgery and radiation.
• Advances in molecular profiling are paving the way for targeted treatment strategies.

Purpose of the Study:

• To review innovative treatment strategies for recurrent high-grade meningiomas.
• To highlight the potential of molecularly driven therapies in managing challenging meningioma cases.

Main Methods:

• Review of recent clinical trials and research on novel therapeutic approaches.
• Focus on targeted therapies, immunotherapy, and radionuclide-based treatments.
• Analysis of pathway-specific inhibitors (angiogenesis, HDAC, FAK, mTOR, CDK4/6).

Main Results:

• Targeted therapies inhibiting specific molecular pathways show early activity in small trials.
• Immunotherapy, including immune checkpoint inhibition (ICI), has demonstrated disease control in some patients.
• Radionuclide-based approaches are also under investigation for recurrent meningiomas.

Conclusions:

• Emerging molecularly targeted treatments offer significant promise for high-grade meningioma patients.
• Larger, randomized clinical trials incorporating molecular testing are crucial to validate these novel therapies.
• These strategies may improve outcomes for patients with limited treatment options.