Chemotherapy and targeted therapies for meningiomas: what is the evidence?
Journal
Current opinion in neurology
ISSN: 1473-6551
Titre abrégé: Curr Opin Neurol
Pays: England
ID NLM: 9319162
Informations de publication
Date de publication:
01 12 2021
01 12 2021
Historique:
pubmed:
12
10
2021
medline:
15
12
2021
entrez:
11
10
2021
Statut:
ppublish
Résumé
Although most meningiomas are slow growing tumors mainly controlled by surgery with or without radiotherapy, aggressive meningiomas that fail these conventional treatments constitute a rare situation, a therapeutic challenge and an unmet need in neuro-oncology. Mutational landscape in recurrent high-grade meningiomas includes mainly NF2 mutation or 22q chromosomal deletion, whereas telomerase reverse transcriptase promoter, BAP-1 and CDK2NA mutations were also found in aggressive meningiomas. Pi3K-Akt-mTOR pathway is currently the most relevant intracellular signaling pathway target in meningiomas with preliminary clinical activity observed. Assessment of drug activity with progression free survival rate at 6 months is challenging in regard to meningioma growth rate heterogeneity, so that 3-dimensional growth rate before and during treatment could be considered in the future to selected new active drugs. Despite a low evidence level, some systemic therapies may be considered for patients with recurrent meningioma not amenable to further surgery or radiotherapy. In recurrent high-grade meningioma, everolimus-octreotide combination, bevacizumab, sunitinib and peptide receptor radionuclide therapy exhibit a signal of activity that may justify their clinical use. Despite a lack of clear signal of activity to date, immunotherapy may offer new perspectives in the treatment of these refractory tumors.
Identifiants
pubmed: 34629433
doi: 10.1097/WCO.0000000000001002
pii: 00019052-202112000-00014
doi:
Substances chimiques
Octreotide
RWM8CCW8GP
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
857-867Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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