Pathophysiological role and clinical applications of HER-2 expression in meningiomas: a systematic review

Although typically benign, malignant meningiomas represent 1-3% of cases and exhibit poor survival rates. Environmental and genetic risk factors, including neurofibromatosis type 2 (NF2), obesity, and hormone-related exposure, influence meningioma development.

This study investigated HER2 expression in meningiomas, exploring its potential as a therapeutic target and examining its role in tumor pathophysiology and grade progression.

A systematic review was conducted through a comprehensive search of the PubMed database, and 12 studies meeting the inclusion criteria were selected. Studies focusing on HER-2/neu expression in meningiomas, published in English, and demonstrating methodological consistency were included in our study.

HER2 overexpression and gene amplification were identified in meningiomas, with higher expression correlating with tumor grade and recurrence rates. HER2-positive meningiomas exhibit enhanced invasion, migration, and proliferation via the HER2/PI3K/AKT pathway, implicating HER2 as a key player in tumor progression. Experimental studies have demonstrated that HER2 silencing reduces meningioma cell proliferation and angiogenesis by modulating vascular endothelial growth factor and CD34 expression. However, some studies have found no correlation between HER2 expression and meningioma characteristics.

HER2 expression is closely associated with meningioma pathogenesis and grade. This highlights HER2 as a potential biomarker and therapeutic target, warranting further clinical trials to explore HER2-targeted therapies, such as trastuzumab, for aggressive and non-resectable meningiomas.