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State-of-the-Art Research in Meningioma

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 39826

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Special Issue Editors

Dr. Alfredo Conti

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Guest Editor

Unit of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
Interests: neurosurgery; CyberKnife; radiosurgery
Special Issues, Collections and Topics in MDPI journals

Dr. Valeria Barresi

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Co-Guest Editor

Department of Diagnostics and Public Health, P.le L.A. Scuro, University of Verona, 37129 Verona, Italy
Interests: cancer biology; colorectal cancer; neuropathology; surgical pathology; prognostic markers; cancer biomarkers; can-cer diagnostics; molecular biology
Special Issues, Collections and Topics in MDPI journals

Dr. Güliz Acker

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Co-Guest Editor

1. Department of Neurosurgery and Center for Stroke research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
2. Berlin Institute of Health (BIH), 10178 Berlin, Germany
3. Charité CyberKnife Center, Charité Universitätsmedizin Berlin, Berlin, Germany
Interests: neurosurgery; neuro-oncology; targeted therapies; radiosurgery; virtual reality, moyamoya

Special Issue Information

Dear Colleagues,

Meningiomas are the most common primary intracranial tumor, representing up to 35% of all central nervous system neoplasms. Conventionally considered benign tumors, the clinical course of this disease is, actually, remarkably heterogeneous. The cure of most benign meningiomas (World Health Organization (WHO) grade I) can be effortlessly achieved by surgical resection, but some lesions represent an exceptional therapeutic challenge because of either the basal location and relationships with critical neuro-vascular structure or the aggressive biological behavior. Recurrences at 10 years occur in more than 20% of patients after a successful initial treatment for benign tumors, and atypical and anaplastic meningiomas (classified as WHO grade II and III, respectively) represent approximately 10%–20% and 5% of all meningioma. In such cases, systemic treatments provide unsatisfactory results, and securing durable, long-term disease control in this setting is still difficult. As a consequence, in a substantial number of patients, meningiomas remain a life-long problem that finally affects survival expectations. Thus, there is an unmet need to improve the overall management of meningiomas under several standpoints. Improvement of current knowledge of tumor biology and potential therapeutic targets, identification of biomarkers to detect patients who are at risk of recurrence or aggressive clinical course, new surgical techniques to achieve safer surgical resection, innovative radiotherapy and nuclear medicine approaches are all fields to be better explored.

This Special Issue aims to cover innovative research articles and updated reviews from experts in the fields of basic, translational, and clinical research of meningioma. Emphasis will be put on recent therapeutic advancements in meningioma, and cutting-edge research in tumor biology, biomarkers, and imaging will be welcome to complement this Special Issue dedicated to meningiomas.

Prof. Dr. Alfredo Conti
Prof. Dr. Valeria Barresi
Dr. Güliz Acker
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

meningioma
surgery
radiosurgery
radiometabolic therapy
immunotherapy
tumor biology
tumor biomarkers

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Published Papers (13 papers)

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10 pages, 1362 KiB

Open AccessArticle

NF2 Alteration/22q Loss Is Associated with Recurrence in WHO Grade 1 Sphenoid Wing Meningiomas

by Yu Sakai, Satoru Miyawaki, Yu Teranishi, Atsushi Okano, Kenta Ohara, Hiroki Hongo, Daiichiro Ishigami, Daisuke Shimada, Jun Mitsui, Hirofumi Nakatomi and Nobuhito Saito

Cancers 2022, 14(13), 3183; https://doi.org/10.3390/cancers14133183 - 29 Jun 2022

Viewed by 1911

Abstract

Sphenoid wing meningiomas account for 11–20% of all intracranial meningiomas and have a higher recurrence rate than those at other sites. Recent molecular biological analyses of meningiomas have proposed new subgroups; however, the correlation between genetic background and recurrence in sphenoid wing meningiomas has not yet been fully elucidated. In this study, we evaluated the clinical characteristics, pathological diagnosis, and molecular background of 47 patients with sphenoid wing meningiomas. Variants of NF2, AKT1, KLF4, SMO, POLR2A, PIK3CA, TRAF7, and TERT were determined using Sanger sequencing, and 22q loss was detected using multiplex ligation-dependent probe amplification. Alterations were localized at NF2 in 11 cases, had other genotypes in 17 cases, and were not detected in 12 cases. Interestingly, WHO grade 1 meningiomas with NF2 alteration/22q loss (p = 0.008) and a MIB-1 labeling index > 4 (p = 0.03) were associated with a significantly shorter recurrence-free survival, and multivariate analysis revealed that NF2 alteration/22q loss was associated with recurrence (hazard ratio, 13.1). The duration of recurrence was significantly shorter for meningiomas with NF2 alteration/22q loss (p = 0.0007) even if gross-total resection was achieved. Together, these findings suggest that NF2 alteration/22q loss is associated with recurrence in WHO grade 1 sphenoid wing meningiomas. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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12 pages, 2264 KiB

Open AccessArticle

Management of Medial Sphenoid Wing Meningioma Involving the Cavernous Sinus: A Single-Center Series of 105 Cases

by Waseem Masalha, Dieter Henrik Heiland, Christine Steiert, Marie T. Krüger, Daniel Schnell, Pamela Heiland, Marco Bissolo, Anca-L. Grosu, Oliver Schnell, Jürgen Beck and Jürgen Grauvogel

Cancers 2022, 14(9), 2201; https://doi.org/10.3390/cancers14092201 - 28 Apr 2022

Cited by 5 | Viewed by 3006

Abstract

Objective: Medial sphenoid wing meningiomas are among the three most common intracranial meningiomas. These tumors pose a challenge to neurosurgeons in terms of surgical treatment, as they may involve critical neurovascular structures and invade the cavernous sinus. In case of the latter, a complete resection may not be achievable. The purpose of this study was to investigate prognostic features affecting recurrence and progression-free survival (PFS) of medial sphenoid wing meningiomas involving the cavernous sinus, focusing on the contribution of surgery and postoperative radiotherapy. Methods: A retrospective analysis was conducted of the database of our institution, and 105 cases of medial sphenoid wing meningioma with invasion of the cavernous sinus, which were treated between 1998 and 2019, were included. Surgical treatment only was performed in 64 cases, and surgical treatment plus postoperative radiotherapy was performed in 41 cases. Kaplan–Meier analysis was conducted to estimate median survival and PFS rates, and Cox regression analysis was applied to determine significant factors that were associated with each therapeutic modality. Results: The risk of recurrence was significantly reduced after near-total resection (NTR) (p-value = 0.0011) compared to subtotal resection. Progression-free survival was also significantly prolonged after postoperative radiotherapy (p-value = 0.0002). Conclusions: Maximal safe resection and postoperative stereotactic radiotherapy significantly reduced the recurrence rate of medial sphenoid wing meningiomas with infiltration of the cavernous sinus. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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10 pages, 1268 KiB

Open AccessArticle

The Immunohistochemical Loss of H3K27me3 in Intracranial Meningiomas Predicts Shorter Progression-Free Survival after Stereotactic Radiosurgery

by Serena Ammendola, Paola Chiara Rizzo, Michele Longhi, Emanuele Zivelonghi, Serena Pedron, Giampietro Pinna, Francesco Sala, Antonio Nicolato, Aldo Scarpa and Valeria Barresi

Cancers 2022, 14(7), 1718; https://doi.org/10.3390/cancers14071718 - 28 Mar 2022

Cited by 10 | Viewed by 2045

Abstract

The immunohistochemical loss of histone H3 trimethylated in lysine 27 (H3K27me3) was recently shown to predict recurrence of meningiomas after surgery. However, its association with tumor progression after stereotactic radiosurgery (SRS) is unexplored. To investigate whether H3K27 methylation status may predict progression-free survival (PFS) after SRS, we assessed H3K27me3 immunoexpression in thirty-nine treatment naïve, intracranial, meningiomas, treated with surgery and subsequent SRS for residual (twenty-three cases) or recurrent (sixteen cases) disease. H3K27me3 immunostaining was lost in seven meningiomas, retained in twenty-seven and inconclusive in five. Six of the seven meningiomas (86%) with H3K27me3 loss had tumor progression after SRS, compared to nine of twenty-seven (33%) with H3K27me3 retention (p = 0.0143). In addition, patients harboring a meningioma with H3K27me3 loss had significantly shorter PFS after SRS (range: 10–81 months; median: 34 months), compared to patients featuring a meningioma with retained H3K27me3 (range: 9–143 months; median: 62 months) (p = 0.0036). Nonetheless, tumor sagittal location was the only significant prognostic variable at multivariate analysis for PFS after SRS (p = 0.0142). These findings suggest a previously unreported role of H3K27me3 as a predictor of meningioma progression after SRS for recurrent or residual disease. Modulation of H3K27 methylation status may represent a novel therapeutic strategy to induce radiosensitization of meningiomas. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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16 pages, 3427 KiB

Open AccessArticle

Gemcitabine Cooperates with Everolimus to Inhibit the Growth of and Sensitize Malignant Meningioma Cells to Apoptosis Induced by Navitoclax, an Inhibitor of Anti-Apoptotic BCL-2 Family Proteins

by Masahiro Yamamoto, Shuhei Suzuki, Keita Togashi, Asuka Sugai, Masashi Okada and Chifumi Kitanaka

Cancers 2022, 14(7), 1706; https://doi.org/10.3390/cancers14071706 - 27 Mar 2022

Cited by 6 | Viewed by 2739

Abstract

Despite several clinical trials with encouraging findings, effective standard systemic therapies have yet to be established for malignant meningioma and the prognosis of these patients remains poor. Accumulating preclinical and clinical evidence suggests that gemcitabine is effective against malignant meningioma. To identify drugs with therapeutic effects that may be enhanced in combination with gemcitabine, we screened drugs that have been tested in preclinical and clinical trials for meningioma. In IOMM-Lee and HKBMM malignant meningioma cells, gemcitabine enhanced the growth inhibitory effects of the mTOR inhibitor everolimus, the clinical benefits of which have been demonstrated in patients with meningioma. The synergistic growth inhibitory effects of this combination were accompanied by cellular senescence characterized by an increase in senescence-associated β-galactosidase activity. To enhance the effects of this combination, we screened senolytic drugs that selectively kill senescent cells, and found that navitoclax, an inhibitor of anti-apoptotic BCL-2 family proteins, effectively reduced the number of viable malignant meningioma cells in combination with everolimus and gemcitabine by inducing apoptotic cell death. The suppression of tumor growth in vivo by the combination of everolimus with gemcitabine was significantly stronger than that by either treatment alone. Moreover, navitoclax, in combination with everolimus and gemcitabine, significantly reduced tumor sizes with an increase in the number of cleaved caspase-3-positive apoptotic cells. The present results suggest that the addition of gemcitabine with or without navitoclax to everolimus is a promising strategy that warrants further evaluation in future clinical trials for malignant meningioma. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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13 pages, 12086 KiB

Open AccessArticle

Transient Enlargement in Meningiomas Treated with Stereotactic Radiotherapy

by Ziad Maksoud, Manuel Alexander Schmidt, Yixing Huang, Sandra Rutzner, Sina Mansoorian, Thomas Weissmann, Christoph Bert, Luitpold Distel, Sabine Semrau, Sebastian Lettmaier, Ilker Eyüpoglu, Rainer Fietkau and Florian Putz

Cancers 2022, 14(6), 1547; https://doi.org/10.3390/cancers14061547 - 17 Mar 2022

Cited by 2 | Viewed by 2362

Abstract

To investigate the occurrence of pseudoprogression/transient enlargement in meningiomas after stereotactic radiotherapy (RT) and to evaluate recently proposed volumetric RANO meningioma criteria for response assessment in the context of RT. Sixty-nine meningiomas (benign: 90%, atypical: 10%) received stereotactic RT from January 2005–May 2018. A total of 468 MRI studies were segmented longitudinally during a median follow-up of 42.3 months. Best response and local control were evaluated according to recently proposed volumetric RANO criteria. Transient enlargement was defined as volumetric increase ≥20% followed by a subsequent regression ≥20%. The mean best volumetric response was −23% change from baseline (range, −86% to +19%). According to RANO, the best volumetric response was SD in 81% (56/69), MR in 13% (9/69) and PR in 6% (4/69). Transient enlargement occurred in only 6% (4/69) post RT but would have represented 60% (3/5) of cases with progressive disease if not accounted for. Transient enlargement was characterized by a mean maximum volumetric increase of +181% (range, +24% to +389 %) with all cases occurring in the first year post-RT (range, 4.1–10.3 months). Transient enlargement was significantly more frequent with SRS or hypofractionation than with conventional fractionation (25% vs. 2%, p = 0.015). Five-year volumetric control was 97.8% if transient enlargement was recognized but 92.9% if not accounted for. Transient enlargement/pseudoprogression in the first year following SRS and hypofractionated RT represents an important differential diagnosis, especially because of the high volumetric control achieved with stereotactic RT. Meningioma enlargement during subsequent post-RT follow-up and after conventional fractionation should raise suspicion for tumor progression. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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9 pages, 617 KiB

Open AccessCommunication

Comparison of Active Surveillance to Stereotactic Radiosurgery for the Management of Patients with an Incidental Frontobasal Meningioma—A Sub-Analysis of the IMPASSE Study

by Abdurrahman I. Islim, Georgios Mantziaris, Stylianos Pikis, Ching-Jen Chen, Adomas Bunevicius, Selçuk Peker, Yavuz Samanci, Ahmed M. Nabeel, Wael A. Reda, Sameh R. Tawadros, Amr M. N. El-Shehaby, Khaled Abdelkarim, Reem M. Emad, Violaine Delabar, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, Roman Liscak, Jaromir May, Roberto Martinez Alvarez, Nuria Martinez Moreno, Manjul Tripathi, Douglas Kondziolka, Herwin Speckter, Camilo Albert, Greg N. Bowden, Ronald J. Benveniste, Lawrence Dade Lunsford, Jason P. Sheehan and Michael D. Jenkinson Show full author list Hide full author list

Cancers 2022, 14(5), 1300; https://doi.org/10.3390/cancers14051300 - 3 Mar 2022

Cited by 4 | Viewed by 2806

Abstract

Meningioma is a common incidental finding, and clinical course varies based on anatomical location. The aim of this sub-analysis of the IMPASSE study was to compare the outcomes of patients with an incidental frontobasal meningioma who underwent active surveillance to those who underwent upfront stereotactic radiosurgery (SRS). Data were retrospectively collected from 14 centres. The active surveillance (n = 28) and SRS (n = 84) cohorts were compared unmatched and matched for age, sex, and duration of follow-up (n = 25 each). The study endpoints included tumor progression, new symptom development, and need for further intervention. Tumor progression occurred in 52.0% and 0% of the matched active surveillance and SRS cohorts, respectively (p < 0.001). Five patients (6.0%) treated with SRS developed treatment related symptoms compared to none in the active monitoring cohort (p = 0.329). No patients in the matched cohorts developed symptoms attributable to treatment. Three patients managed with active surveillance (10.7%, unmatched; 12.0%, matched) underwent an intervention for tumor growth with no persistent side effects after treatment. No patients subject to SRS underwent further treatment. Active monitoring and SRS confer a similarly low risk of symptom development. Upfront treatment with SRS improves imaging-defined tumor control. Active surveillance and SRS are acceptable treatment options for incidental frontobasal meningioma. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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20 pages, 3309 KiB

Open AccessArticle

Proliferative Potential, and Inflammatory Tumor Microenvironment in Meningioma Correlate with Neurological Function at Presentation and Anatomical Location—From Convexity to Skull Base and Spine

by Johannes Wach, Tim Lampmann, Ági Güresir, Hartmut Vatter, Ulrich Herrlinger, Albert Becker, Silvia Cases-Cunillera, Michael Hölzel, Marieta Toma and Erdem Güresir

Cancers 2022, 14(4), 1033; https://doi.org/10.3390/cancers14041033 - 18 Feb 2022

Cited by 12 | Viewed by 2784

Abstract

Emerging evidence emphasizes the prognostic importance of meningioma location. The present investigation evaluates whether progression-free survival (PFS), proliferative potential, World Health Organization (WHO) grades, and inflammatory burden differ between anatomical locations (skull base, non-skull base, and spinal) meningiomas. Five-hundred-forty-one patients underwent Simpson grade I or II resection for WHO grade 1 or 2 meningiomas. Univariable analysis revealed that spinal meningioma patients are significantly older, had a worse baseline Karnofsky Performance Status (KPS), higher acute-phase protein levels, lower incidence of WHO grade 2, lower mitotic counts, lower MIB-1 index, and less CD68⁺ macrophage infiltrates. Multivariable analysis identified WHO grade 2 (OR: 2.1, 95% CI: 1.1–3.7, p = 0.02) and cranial location (OR: 3.0, 95% CI: 1.8–4.9, p = 0.001) as independent predictors of diffuse CD68⁺ macrophage infiltrates. The mean PFS in cranial meningiomas was 115.9 months (95% CI: 107.5–124.3), compared to 162.2 months (95% CI: 150.5–174.0; log-rank test: p = 0.02) in spinal meningiomas. Multivariable Cox regression analysis revealed cranial location as an independent predictor (HR: 4.7, 95% CI: 1.0–21.3, p = 0.04) of shortened PFS. Increased MIB-1 indices ≥5% were significantly associated with location-specific deficits at presentation, such as decreased vision and seizure burden. Spinal meningiomas have a significantly longer PFS time and differ from the cranial meningiomas regarding MIB-1 index and density of tumor-associated macrophages. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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12 pages, 2219 KiB

Open AccessArticle

68Ga-DOTATOC-PET/MRI—A Secure One-Stop Shop Imaging Tool for Robotic Radiosurgery Treatment Planning in Patients with Optic Nerve Sheath Meningioma

by Josefine Graef, Christian Furth, Anne Kathrin Kluge, Gueliz Acker, Melina Kord, Zoe Zimmermann, Holger Amthauer, Marcus Makowski, Franziska Loebel, Peter Vajkoczy, Volker Budach and Carolin Senger

Cancers 2021, 13(13), 3305; https://doi.org/10.3390/cancers13133305 - 1 Jul 2021

Cited by 7 | Viewed by 2464

Abstract

Optic nerve sheath meningiomas (ONSM) are rare but can lead to irreversible blindness. Hybrid imaging may enhance tumor delineation and diagnostic accuracy via receptor binding. However, relevant clinical data for ONSM are lacking. We evaluated the feasibility of receptor-based hybrid imaging prior to robotic radiosurgery (RRS). We retrospectively analyzed all of our institution’s patients with suspected ONSM who underwent combined positron emission tomography and magnetic resonance imaging (PET/MRI) with gallium-68-labeled (DOTA0-Phe1-Tyr3) octreotide (Ga68-DOTATOC) before RRS between 2018 and 2019. Eight patients with ten suspected ONSM (female = 7; median age, 51.2 years; IQR, 43.0–66.0) were included. Nine out of ten ONSM were deemed PET-positive with a median standard uptake value (SUV) max of 5.6 (IQR, 2.6–7.8). For all nine ONSM that presented 68Ga-DOTATOC uptake, hybrid PET/MRI was used for target volume contouring prior to RSS. At a median follow-up of 11.7 months (IQR, 9.4–16.4), tumor control was achieved in all patients. Radiosurgery resulted in the improvement of visual acuity in two of eight patients, whereas six showed stable vision. Ga68-DOTATOC-PET/MRI can be used for target volume contouring prior to RRS for ONSM as it enables safe treatment planning and improves diagnostic accuracy. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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Review

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18 pages, 720 KiB

Open AccessReview

The Long and Winding Road: An Overview of the Immunological Landscape of Intracranial Meningiomas

by Giuseppe Roberto Giammalva, Lara Brunasso, Federica Paolini, Roberta Costanzo, Lapo Bonosi, Umberto Emanuele Benigno, Gianluca Ferini, Serena Sava, Cristina Colarossi, Giuseppe Emmanuele Umana, Rosa Maria Gerardi, Carmelo Lucio Sturiale, Alessio Albanese, Domenico Gerardo Iacopino and Rosario Maugeri

Cancers 2022, 14(15), 3639; https://doi.org/10.3390/cancers14153639 - 26 Jul 2022

Cited by 9 | Viewed by 2297

Abstract

The role of immunotherapy is gaining ever-increasing interest in the neuro-oncological field, and this is also expanding to the management of intracranial meningioma. Meningiomas are still the most common primary adult tumor of the CNS, and even though surgery and/or radiotherapy still represent cornerstones of their treatment, recent findings strongly support the potential role of specific immune infiltrate cells, their features and genomics, for the application of personalized treatments and prognostic implications. According to the PRISMA guidelines, systematic research in the most updated platform was performed in order to provide a descriptive and complete overview about the characteristics, role and potential implications of immunology in meningioma tumors. Seventy articles were included and analyzed in the present paper. The meningioma microenvironment reveals complex immune tumor-immune cells interactions that may definitely influence tumor progression, as well as offering unexpected opportunities for treatment. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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9 pages, 658 KiB

Open AccessReview

Brain Invasion in Meningioma—A Prognostic Potential Worth Exploring

by Felix Behling, Johann-Martin Hempel and Jens Schittenhelm

Cancers 2021, 13(13), 3259; https://doi.org/10.3390/cancers13133259 - 29 Jun 2021

Cited by 24 | Viewed by 3592

Abstract

Most meningiomas are slow growing tumors arising from the arachnoid cap cells and can be cured by surgical resection or radiation therapy in selected cases. However, recurrent and aggressive cases are also quite common and challenging to treat due to no established treatment alternatives. Assessment of the risk of recurrence is therefore of utmost importance and several prognostic clinical and molecular markers have been established. Additionally, the identification of invasive growth of meningioma cells into CNS tissue was demonstrated to lead to a higher risk of recurrence and was therefore integrated into the WHO classification of CNS tumors. However, the evidence for its prognostic impact has been questioned in subsequent studies and its exclusion from the next WHO classification proposed. We were recently able to show the prognostic impact of CNS invasion in a large comprehensive retrospective meningioma cohort including other established prognostic factors. In this review we discuss the growing experiences that have been gained on this matter, with a focus on the currently nonuniform histopathological assessment, imaging characteristics and intraoperative sampling as well as the overall outlook on the future role of this potential prognostic factor. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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11 pages, 25938 KiB

Open AccessReview

STA-MCA Bypass in Carotid Stenosis after Radiosurgery for Cavernous Sinus Meningioma

by Marco Vincenzo Corniola, Marton König and Torstein Ragnar Meling

Cancers 2021, 13(10), 2420; https://doi.org/10.3390/cancers13102420 - 17 May 2021

Cited by 1 | Viewed by 2389

Abstract

Background: Cavernous sinus meningiomas (CSM) are mostly non-surgical tumors. Stereotactic radiosurgery (SRS) or radiotherapy (SRT) allow tumor control and improvement of pre-existing cranial nerve (CN) deficits. We report the case of a patient with radiation-induced internal carotid artery (ICA) stenosis. We complete the picture with a review of the literature of vascular and non-vascular complications following the treatment of CSMs with SRS or SRT. Methods: After a case description, a systematic literature review is presented, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2015 guidelines. Results: 115 abstracts were screened and 70 titles were retained for full-paper screening. A total of 58 articles did not meet the inclusion criteria. There were 12 articles included in our review, with a follow-up ranging from 33 to 120 months. Two cases of post-SRT ischemic stroke and one case of asymptomatic ICA stenosis were described. Non-vascular complications were reported in all articles. Conclusion: SRS and SRT carry fewer complications than open surgery, with similar rates of tumor control. Our case shows the importance of a follow-up of irradiated CSMs not only by a radio-oncologist, but also by a neurosurgeon, illustrating the importance of multidisciplinary management of CSMs. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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Other

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15 pages, 1940 KiB

Open AccessSystematic Review

Updated Systematic Review on the Role of Brain Invasion in Intracranial Meningiomas: What, When, Why?

by Lara Brunasso, Lapo Bonosi, Roberta Costanzo, Felice Buscemi, Giuseppe Roberto Giammalva, Gianluca Ferini, Vito Valenti, Anna Viola, Giuseppe Emmanuele Umana, Rosa Maria Gerardi, Carmelo Lucio Sturiale, Alessio Albanese, Domenico Gerardo Iacopino and Rosario Maugeri

Cancers 2022, 14(17), 4163; https://doi.org/10.3390/cancers14174163 - 27 Aug 2022

Cited by 6 | Viewed by 2025

Abstract

Several recent studies are providing increasing insights into reliable markers to improve the diagnostic and prognostic assessment of meningioma patients. The evidence of brain invasion (BI) signs and its associated variables has been focused on, and currently, scientific research is investing in the study of key aspects, different methods, and approaches to recognize and evaluate BI. This paradigm shift may have significant repercussions for the diagnostic, prognostic, and therapeutic approach to higher-grade meningioma, as long as the evidence of BI may influence patients’ prognosis and inclusion in clinical trials and indirectly impact adjuvant therapy. We intended to review the current knowledge about the impact of BI in meningioma in the most updated literature and explore the most recent implications on both clinical practice and trials and future directions. According to the PRISMA guidelines, systematic research in the most updated platform was performed in order to provide a complete overview of characteristics, preoperative applications, and potential implications of BI in meningiomas. Nineteen articles were included in the present paper and analyzed according to specific research areas. The detection of brain invasion could represent a crucial factor in meningioma patients’ management, and research is flourishing and promising. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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16 pages, 1417 KiB

Open AccessSystematic Review

Mouse Models in Meningioma Research: A Systematic Review

by Julien Boetto, Matthieu Peyre and Michel Kalamarides

Cancers 2021, 13(15), 3712; https://doi.org/10.3390/cancers13153712 - 26 Jul 2021

Cited by 15 | Viewed by 6844

Abstract

Meningiomas are the most frequent primitive central nervous system tumors found in adults. Mouse models of cancer have been instrumental in understanding disease mechanisms and establishing preclinical drug testing. Various mouse models of meningioma have been developed over time, evolving in light of new discoveries in our comprehension of meningioma biology and with improvements in genetic engineering techniques. We reviewed all mouse models of meningioma described in the literature, including xenograft models (orthotopic or heterotopic) with human cell lines or patient derived tumors, and genetically engineered mouse models (GEMMs). Xenograft models provided useful tools for preclinical testing of a huge range of innovative drugs and therapeutic options, which are summarized in this review. GEMMs offer the possibility of mimicking human meningiomas at the histological, anatomical, and genetic level and have been invaluable in enabling tumorigenesis mechanisms, including initiation and progression, to be dissected. Currently, researchers have a range of different mouse models that can be used depending on the scientific question to be answered. Full article

(This article belongs to the Special Issue State-of-the-Art Research in Meningioma)

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