Targeted and Personalized Therapy for Difficult Benign Brain Tumors: A Review

Area of Science:

• Neuro-oncology
• Molecular Pathology
• Genomics

Background:

• Difficult benign intracranial tumors like meningiomas and schwannomas cause significant patient morbidity.
• Limited treatment options necessitate individualized approaches beyond traditional surgery and histology.

Purpose of the Study:

• To review novel treatment innovations for difficult benign brain tumors.
• Prioritize meningiomas, schwannomas, neurofibromatosis-associated neoplasms, and pituitary neuroendocrine tumors.
• Compare treatment strategies with low-grade gliomas.

Main Methods:

• Synthesized current knowledge on targeted therapies for various brain tumors.
• Reviewed tumor genomics and molecular markers.
• Incorporated methylation-based classification, immunohistochemistry, and functional assays.

Main Results:

• DNA methylation models predict post-surgical outcomes and radiotherapy response for risk stratification.
• Early evidence supports targeted treatments like cMET blockade and brigatinib in preclinical models.
• Pituitary neuroendocrine tumor organoid data shows therapeutic potential.

Conclusions:

• Molecular profiling and functional testing should guide targeted treatment decisions.
• Evidence gaps exist, particularly in biomarker-defined prospective trials for clinical implementation.