Novel Advances in Treatment of Meningiomas: Prognostic and Therapeutic Implications

Abstract

Meningiomas are the most frequent histotypes of tumors of the central nervous system. Their incidence is approximately 35% of all primary brain tumors. Although they have the status of benign lesions, meningiomas are often associated with a decreased quality of life due to focal neurological deficits that may be related. The optimal treatment is total resection. Histological grading is the most important prognostic factor. Recently, molecular alterations have been identified that are specifically related to particular phenotypes and, probably, are also responsible for grading, site, and prognostic trend. Meningiomas recur in 10–25% of cases. In these cases, and in patients with atypical or anaplastic meningiomas, the methods of approach are relatively insufficient. To date, data on the molecular biology, genetics, and epigenetics of meningiomas are insufficient. To achieve an optimal treatment strategy, it is necessary to identify the mechanisms that regulate tumor formation and progression. Combination therapies affecting multiple molecular targets are currently opening up and have significant promise as adjuvant therapeutic options. We review the most recent literature to identify studies investigating recent therapeutic treatments recently used for meningiomas.

Impact of Heavy Metals on Glioma Tumorigenesis

“…Meningiomas are the most frequent primary tumors of the central nervous system [62], representing approximately 35% of all primary CNS tumors [63]. Ionizing radiation appears to be, to date, the only environmental risk factor [64].…”

Related mechanisms, current treatments, and new perspectives in meningioma

“…Meningiomas are more common in females during puberty and the reproductive years; however, there is no clear link between reproductive hormone levels and meningioma 38 . It is clarified that an anti‐estrogenic drug called tamoxifen does not show significant effectiveness in the treatment; however, progesterone antagonists such as mifepristone can be used for unresectable meningioma treatment 39 …”