Towards Molecular Classification of Meningioma: Evolving Treatment and Diagnostic Paradigms

Proctor, Dustin T; Ramachandran, Sudheesh; Lama, Sanju; Sutherland, Garnette R.

doi:10.1016/j.wneu.2018.08.019

Cited by 52 publications

(54 citation statements)

References 70 publications

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“…The E17K mutation in AKT1 leads to constitutive activation of its gene product, protein kinase B, and stimulates downstream mTOR signaling (12,19,26). Known to be oncogenic in many other cancer types (27), this mutation is found in 7-12% of grade I meningiomas (3,11,12,19), is enriched in the meningothelial subtype (11), and is predictive of decreased progression free survival in olfactory groove tumors (28). Altering the same signaling pathway PIK3CA mutations are also found in ∼7% of non-NF2 tumors, and are mutually exclusive with AKT1 mutation (26).…”

Section: Non-nf2 Meningiomamentioning

confidence: 99%

“…Best known for its role in pluripotency, Klf4 is thought to act as a tumor suppressor in meningioma, being robustly expressed in low grade tumors and downregulated in anaplastic tumors (30). At the genetic level, KLF4 is mutated in ∼12% of grade I meningiomas (3,11), virtually all of which are of the secretory sub-type and also harbor TRAF7 mutations (31). All identified KLF4 mutations result in a K409Q substitution within the DNA binding domain, which likely alters or blocks key protein functions (32).…”

Section: Non-nf2 Meningiomamentioning

confidence: 99%

“…Mutations in the gene smoothened (SMO), which result in L412F or W535L substitutions lead to functional activation of Hedgehog signaling in meningioma (3,11,12,19). These mutations are present in ∼5.5% of grade I meningiomas, and are mutually exclusive with TRAF7, KLF4, and AKT1 mutations (3,26). Interestingly, meningiomas with the L412F mutation are more likely to recur (3), and are enriched at the midline, perhaps reflective of the key role Hedgehog signaling plays in hemisphere separation during development (19).…”

Section: Non-nf2 Meningiomamentioning

confidence: 99%

“…The dura mater, arachnoid mater, and pia mater, are the three protective membranes that surround the brain and spinal cord, together forming the meninges (1)(2)(3). Tumors arising from this tissue, called meningiomas, are the most common primary intracranial tumors of the central nervous system (4).…”

Section: Introductionmentioning

confidence: 99%

“…Standard of care treatment for meningioma is based primarily on patient status and WHO grading when biopsy is available (3). As there are no screening criteria for meningioma, findings in asymptomatic patients are often incidental (3). For these patients, observation may be the primary treatment approach.…”

Section: Introductionmentioning

confidence: 99%

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Recent Advances in Meningioma Immunogenetics

2020

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Meningiomas are relatively common, and typically benign intracranial tumors, which in many cases can be cured by surgical resection. However, less prevalent, high grade meningiomas, grow quickly, and recur frequently despite treatment, leading to poor patient outcomes. Across tumor grades, subjective guidelines for histological analysis can preclude accurate diagnosis, and an insufficient understanding of recurrence risk can cloud the choice of optimal treatment. Improved diagnostic and prognostic markers capable of discerning between the 15 heterogeneous WHO recognized meningioma subtypes are necessary to improve disease management and identify new targeted drug treatments. In this review, we show the advances in molecular profiling and immunophenotyping of meningiomas, which may lead to the development of new personalized therapeutic strategies.

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Section: Non-nf2 Meningiomamentioning

confidence: 99%

Section: Non-nf2 Meningiomamentioning

confidence: 99%

Section: Non-nf2 Meningiomamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recent Advances in Meningioma Immunogenetics

2020

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Related mechanisms, current treatments, and new perspectives in meningioma

Inetas‐Yengin,

Bayrak

2024

Genes Chromosomes & Cancer

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Meningiomas are non‐glial tumors that are the most common primary brain tumors in adults. Although meningioma can possibly be cured with surgical excision, variations in atypical/anaplastic meningioma have a high recurrence rate and a poor prognosis. As a result, it is critical to develop novel therapeutic options for high‐grade meningiomas. This review highlights the current histology of meningiomas, prevalent genetic and molecular changes, and the most extensively researched signaling pathways and therapies in meningiomas. It also reviews current clinical studies and novel meningioma treatments, including immunotherapy, microRNAs, cancer stem cell methods, and targeted interventions within the glycolysis pathway. Through the examination of the complex landscape of meningioma biology and the highlighting of promising therapeutic pathways, this review opens the way for future research efforts aimed at improving patient outcomes in this prevalent intracranial tumor entity.

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Differentiation Between Benign and Nonbenign Meningiomas by Using Texture Analysis From Multiparametric MRI

Chen

et al. 2019

Magnetic Resonance Imaging

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BackgroundIt is difficult to prospectively differentiate between benign (World Health Organization [WHO] I) and nonbenign (WHO II and III) meningiomas.PurposeTo evaluate the feasibility of preoperative differentiation between benign and nonbenign meningiomas by using texture analysis from multiparametric MR data.Study TypeRetrospective.SubjectsIn all, 184 patients with meningioma (139 benign and 45 nonbenign) were included as the training cohort and 79 patients with meningioma (60 benign and 19 nonbenign) were included as the external validation cohort.Field Strength/SequenceT1‐weighted, T2‐weighted, and contrast‐enhanced T1‐weighted imaging were performed on 1.5 or 3.0T MR systems from two centers.AssessmentTumor segmentation and radiological characteristic (RC) evaluation were performed by experienced radiologists. The texture features were extracted from preprocessed images and combined with RCs, and then the combined features were reduced by using a two‐step feature selection. Three single‐sequence models and a multiparametric MRI (the combination of single sequences) model were constructed and then evaluated with the external validation cohort.Statistical TestsArea under receiver operating characteristic curve (AUC), accuracy (Acc), f1‐score (F1), sensitivity (Sen), and specificity (Spec), were calculated to quantify the performance of the models.ResultsAmong the four texture models, the multiparametric MRI model demonstrated the best performance for differentiating between benign and nonbenign meningiomas in both the training and external validation cohorts (AUC 0.91, Acc 89%, F1 0.88, Sen 0.93, and Spec 0.87 in the training cohort; AUC 0.83, Acc 80%, F1 0.77, Sen 0.84, and Spec 0.78 in the validation cohort).Data ConclusionNonbenign meningiomas might be preoperatively differentiated from benign meningiomas by using texture analysis from multiparametric MR data.Level of Evidence: 3Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;51:1810–1820.

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Towards Molecular Classification of Meningioma: Evolving Treatment and Diagnostic Paradigms

Cited by 52 publications

References 70 publications

Recent Advances in Meningioma Immunogenetics

Recent Advances in Meningioma Immunogenetics

Related mechanisms, current treatments, and new perspectives in meningioma

Differentiation Between Benign and Nonbenign Meningiomas by Using Texture Analysis From Multiparametric MRI

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