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Molecular classification and grading of meningioma

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Abstract

Purpose

Meningiomas are the most common primary intracranial tumor in older adults (Ostrom et al. in Neuro Oncol 21(Suppl 5):v1–v100, 2019). Treatment is largely driven by, in addition to patient characteristics and extent of resection/Simpson grade, the World Health Organization (WHO) grading of meningiomas. The current grading scheme, based predominantly on histologic features and only limited molecular characterization of these tumors (WHO Classification of Tumours Editorial Board, in: Central nervous system tumours, International Agency for Research on Cancer, Lyon, 2021), (Mirian et al. in J Neurol Neurosurg Psychiatry 91(4):379–387, 2020), does not consistently reflect the biologic behavior of meningiomas. This leads to both under-treatment and over-treatment of patients, and hence, suboptimal outcomes (Rogers et al. in Neuro Oncol 18(4):565–574). The goal of this review is to synthesize studies to date investigating molecular features of meningiomas as they relate to patient outcomes, in order to clarify best practices in assessing and, therefore, treating meningiomas.

Methods

The available literature of genomic landscape and molecular features of in meningioma was screened using PubMed.

Results

Greater understanding of meningiomas is reached by integrating histopathology, mutational analysis, DNA copy number changes, DNA methylation profiles, and potentially additional modalities to fully capture the clinical and biologic heterogeneity of these tumors.

Conclusion

Diagnosis and classification of meningioma is best accomplished using a combination of histopathology with genomic and epigenomic factors. Future classification schemes may benefit from such an integrated approach.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Neuropathology, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    MacLean P. Nasrallah

  2. Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA

    Kenneth D. Aldape

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  1. MacLean P. Nasrallah
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  2. Kenneth D. Aldape
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MPN and KDA: wrote the main manuscript text, and prepared the figures and table.

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Correspondence to MacLean P. Nasrallah.

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Nasrallah, M.P., Aldape, K.D. Molecular classification and grading of meningioma. J Neurooncol 161, 373–381 (2023). https://doi.org/10.1007/s11060-022-04228-9

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