Meningioma: Novel Diagnostic and Therapeutic Approaches

<b>Background/Objectives</b>: Meningiomas are the most common intracranial tumors. Surgery and radiation therapy are the cornerstones of treatment and no standard of care therapy exists for refractory meningiomas. This manuscript aims to provide a comprehensive review of novel diagnostic...

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Main Authors: Carlen A. Yuen, Michelle Zheng, Max A. Saint-Germain, David O. Kamson
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/13/3/659
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author Carlen A. Yuen
Michelle Zheng
Max A. Saint-Germain
David O. Kamson
author_facet Carlen A. Yuen
Michelle Zheng
Max A. Saint-Germain
David O. Kamson
author_sort Carlen A. Yuen
collection DOAJ
description <b>Background/Objectives</b>: Meningiomas are the most common intracranial tumors. Surgery and radiation therapy are the cornerstones of treatment and no standard of care therapy exists for refractory meningiomas. This manuscript aims to provide a comprehensive review of novel diagnostic and therapeutic approaches against these tumors. <b>Methods</b>: A search for the existing literature on systemic therapies for meningiomas was performed on PubMed and a search for presently accruing clinical trials was performed on ClinicalTrials.gov. <b>Results</b>: Systemic treatments, including chemotherapy, somatostatin analogs, anti-hormone therapy, and anti-angiogenic therapy, have been extensively studied with marginal success. Targeted therapies are actively being studied for the treatment of meningiomas, including focal adhesion kinase (FAK), sonic hedgehog signaling pathway, phosphoinositide-3-kinase (<i>PI3K</i>), and cyclin-dependent kinases (<i>CDK</i>) inhibitors. These driver mutations are present only in a subset of meningiomas. In stark contrast, somatostatin receptor 2 (SSTR2) is ubiquitously expressed in meningiomas and was formerly targeted with somatostatin analogs with modest success. Theranostic SSTR2-targeting via [<sup>68</sup>Ga]DOTATATE for PET imaging and β-emitting [<sup>177</sup>Lu]DOTATATE for the treatment of meningiomas are currently under active investigation. <b>Conclusions</b>: A nuanced approach is needed for the treatment of refractory meningiomas. Targeted therapies show promise.
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spelling doaj-art-93dfb4fe5a404fd2bf5bcfc4d266d2ef2025-08-20T02:11:15ZengMDPI AGBiomedicines2227-90592025-03-0113365910.3390/biomedicines13030659Meningioma: Novel Diagnostic and Therapeutic ApproachesCarlen A. Yuen0Michelle Zheng1Max A. Saint-Germain2David O. Kamson3Chao Family Comprehensive Cancer Center, University of California, Irvine, CA 92697, USACharlie Dunlop School of Biological Sciences, University of California Irvine, Irvine, CA 92697, USAThe Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD 21231, USAThe Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD 21231, USA<b>Background/Objectives</b>: Meningiomas are the most common intracranial tumors. Surgery and radiation therapy are the cornerstones of treatment and no standard of care therapy exists for refractory meningiomas. This manuscript aims to provide a comprehensive review of novel diagnostic and therapeutic approaches against these tumors. <b>Methods</b>: A search for the existing literature on systemic therapies for meningiomas was performed on PubMed and a search for presently accruing clinical trials was performed on ClinicalTrials.gov. <b>Results</b>: Systemic treatments, including chemotherapy, somatostatin analogs, anti-hormone therapy, and anti-angiogenic therapy, have been extensively studied with marginal success. Targeted therapies are actively being studied for the treatment of meningiomas, including focal adhesion kinase (FAK), sonic hedgehog signaling pathway, phosphoinositide-3-kinase (<i>PI3K</i>), and cyclin-dependent kinases (<i>CDK</i>) inhibitors. These driver mutations are present only in a subset of meningiomas. In stark contrast, somatostatin receptor 2 (SSTR2) is ubiquitously expressed in meningiomas and was formerly targeted with somatostatin analogs with modest success. Theranostic SSTR2-targeting via [<sup>68</sup>Ga]DOTATATE for PET imaging and β-emitting [<sup>177</sup>Lu]DOTATATE for the treatment of meningiomas are currently under active investigation. <b>Conclusions</b>: A nuanced approach is needed for the treatment of refractory meningiomas. Targeted therapies show promise.https://www.mdpi.com/2227-9059/13/3/659meningioma177-LutetiumPRRTDOTATATE PEToctreotide<i>NF2</i>
spellingShingle Carlen A. Yuen
Michelle Zheng
Max A. Saint-Germain
David O. Kamson
Meningioma: Novel Diagnostic and Therapeutic Approaches
Biomedicines
meningioma
177-Lutetium
PRRT
DOTATATE PET
octreotide
<i>NF2</i>
title Meningioma: Novel Diagnostic and Therapeutic Approaches
title_full Meningioma: Novel Diagnostic and Therapeutic Approaches
title_fullStr Meningioma: Novel Diagnostic and Therapeutic Approaches
title_full_unstemmed Meningioma: Novel Diagnostic and Therapeutic Approaches
title_short Meningioma: Novel Diagnostic and Therapeutic Approaches
title_sort meningioma novel diagnostic and therapeutic approaches
topic meningioma
177-Lutetium
PRRT
DOTATATE PET
octreotide
<i>NF2</i>
url https://www.mdpi.com/2227-9059/13/3/659
work_keys_str_mv AT carlenayuen meningiomanoveldiagnosticandtherapeuticapproaches
AT michellezheng meningiomanoveldiagnosticandtherapeuticapproaches
AT maxasaintgermain meningiomanoveldiagnosticandtherapeuticapproaches
AT davidokamson meningiomanoveldiagnosticandtherapeuticapproaches