Update on Meningiomas

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Evaluate patients with grade II and III meningiomas for possible implementation of adjuvant radiation therapy.Describe options of systemic treatment of refractory meningiomas with hydroxyurea, somatostatin analogues, or CAV multi-agent chemotherapy. CME This article is available for continuing medical education credit at CME.TheOncologist.com Although meningiomas are the most common tumor in the central nervous system, their incidence, epidemiology, and clinical outcomes have historically been poorly defined. This has been attributed to their benign course, difficulty obtaining histologic diagnosis, and lack of uniform database registration. Their clinical behavior can range from a silent incidentaloma to a lethal tumor. Projections of an aging population should raise medical awareness of an expectant rise in the incidence of meningiomas. This disease increases with advancing age, has a female predilection, and exposure to ionizing radiation is associated with a higher risk for disease development. There have been minimal advances in treatment, except in radiation therapy. Although no U.S. Food and Drug Administration–approved systemic therapy exists, there are treatment options that include hydroxyurea and sandostatin. Currently, no molecularly targeted therapy has provided clinical benefit, although recurring molecular alterations are present and novel therapies are being investigated.