Pellerino Alessia, Bruno Francesco, Palmiero Rosa, Pronello Edoardo, Bertero Luca, Soffietti Riccardo, Rudà Roberta
Division of Neuro-Oncology, Department Neuroscience, University and City of Health and Science Hospital, 10126 Turin, Italy.
Department of Neurology Unit, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy.
Cancers (Basel). 2022 Apr 30;14(9):2256. doi: 10.3390/cancers14092256.
Meningiomas are common intracranial tumors that can be treated successfully in most cases with surgical resection and/or adjuvant radiotherapy. However, approximately 20% of patients show an aggressive clinical course with tumor recurrence or progressive disease, resulting in significant morbidity and increased mortality. Despite several studies that have investigated different cytotoxic agents in aggressive meningiomas in the past several years, limited evidence of efficacy and clinical benefit has been reported thus far. Novel molecular alterations have been linked to a particular clinicopathological phenotype and have been correlated with grading, location, and prognosis of meningiomas. In this regard, , , and mutations are typical of anterior skull base meningiomas, whereas mutations are specific for secretory histology, and alterations are common in progressive rhabdoid meningiomas. Alterations in , , and correlate with poor outcomes. Moreover, some actionable mutations, including , , and , regulate meningioma growth and are under investigation in clinical trials. PD-L1 and/or M2 macrophage expression in the microenvironment provides evidence for the investigation of immunotherapy in progressive meningiomas.
脑膜瘤是常见的颅内肿瘤，大多数情况下可通过手术切除和/或辅助放疗成功治疗。然而，约20%的患者表现出侵袭性临床病程，出现肿瘤复发或疾病进展，导致显著的发病率和死亡率增加。尽管在过去几年中有多项研究调查了侵袭性脑膜瘤中的不同细胞毒性药物，但迄今为止报道的疗效和临床获益证据有限。新的分子改变与特定的临床病理表型相关，并与脑膜瘤的分级、位置和预后相关。在这方面， 、 和 突变是前颅底脑膜瘤的典型特征，而 突变是分泌型组织学所特有的， 改变在进展性横纹肌样脑膜瘤中很常见。 、 和 的改变与不良预后相关。此外，一些可靶向治疗的突变，包括 、 和 ，调节脑膜瘤生长，正在临床试验中进行研究。微环境中PD-L1和/或M2巨噬细胞的表达为进展性脑膜瘤的免疫治疗研究提供了证据。
