Advances in Molecular Classification and Therapeutic Opportunities in Meningiomas

Curr Oncol Rep. 2020 Jul 3;22(8):84. doi: 10.1007/s11912-020-00937-4.

Abstract

Purpose of review: Our understanding of the genetic and epigenetic alterations in meningioma and the underlying tumor biology of meningioma has significantly changed over the past decade and resulted in revision of prognostically relevant meningioma subclasses within and beyond the WHO classification of CNS tumors.

Recent findings: The 2016 WHO classification of CNS tumors recognizes WHO grade I, II, and III based on histopathological features. Recent work has identified genetic alterations with prognostic implications, including mutations of the TERT promoter, loss of function of the DMD gene, and inactivation of the tumor suppressor BAP-1. Studies of DNA methylation patterns in meningiomas have resulted in a novel and prognostically relevant meningioma subclassification schema. There have been major advances in our understanding of prognostically relevant genetic and epigenetic changes in meningioma which will hopefully allow for improvement in clinical trial design and the development of more effective therapies for meningioma.

Keywords: 177Lu-DOTATATE; AKT1; Anaplastic; Atypical; BAP-1; H3K27me3; Immunotherapy; Lutathera; Meningioma; Methylation class; Methylome; Molecular targets; NF2; Neurofibromin 2; Outcome; PFS-6 benchmark; Radiation; SMO; SSTR2; TERT; Trabectedin; WHO classification of CNS tumors.

Publication types

  • Review

MeSH terms

  • DNA Copy Number Variations
  • DNA Methylation
  • Humans
  • Meningeal Neoplasms / classification
  • Meningeal Neoplasms / genetics*
  • Meningeal Neoplasms / immunology
  • Meningeal Neoplasms / therapy
  • Meningioma / classification
  • Meningioma / genetics*
  • Meningioma / immunology
  • Meningioma / therapy
  • Mutation
  • Neurofibromin 2 / genetics
  • Phosphatidylinositol 3-Kinases / physiology
  • Signal Transduction / physiology
  • Tumor Microenvironment

Substances

  • NF2 protein, human
  • Neurofibromin 2