Meningioma is the most common primary brain tumor in adults, arising from the meninges that cover the brain and spinal cord. Most are benign (grade 1) and can often be observed or cured with surgery, but grade 2 and grade 3 meningiomas have significant recurrence rates, and even grade 1 tumors in surgically inaccessible locations pose serious management challenges.
What's actually going on in research
Surgery and stereotactic radiosurgery are the mainstays of treatment, but no drug therapy has been approved for meningioma. The genomic landscape of meningioma is increasingly well characterized, with NF2 mutations being most common and other drivers including AKT1, SMO, and TRAF7 mutations defining distinct subgroups. Trials are now testing targeted drugs matched to these mutations, as well as somatostatin receptor–targeted therapies and immune checkpoint inhibitors for high-grade recurrent disease.
Mutation-matched targeted therapy
Trials are testing SMO inhibitors for SMO-mutant meningiomas and AKT/mTOR inhibitors for AKT1-mutant tumors, exploiting the actionable mutations identified in approximately 20% of meningiomas.
Somatostatin receptor therapy
Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogues is in trials for recurrent and unresectable meningioma, which highly expresses somatostatin receptors — making it an attractive therapeutic target.
Immune checkpoint inhibitors
PD-1 and PD-L1 blocking antibodies are being tested for grade 2 and 3 recurrent meningiomas, which are less immune-cold than low-grade tumors and may respond to immune activation strategies.
What to know before you search
Eligibility depends on meningioma grade, whether resection has been performed, specific tumor mutation profile, and prior radiation.
What types of trials are currently open
- Targeted therapy trials — Testing drugs matched to SMO, AKT1, NF2 pathway, and other specific mutations in meningioma.
- Radionuclide therapy trials — Evaluating PRRT and other radiolabeled somatostatin approaches for unresectable or recurrent meningioma.
- Immune checkpoint inhibitor trials — Testing PD-1/PD-L1 blockade for high-grade recurrent meningioma.
- Radiation therapy trials — Comparing stereotactic radiosurgery, fractionated radiation, and proton therapy for different tumor locations and grades.
- Observation versus treatment trials — Studying when active surveillance is safe for small asymptomatic meningiomas versus when early treatment is better.
Recently added Meningioma trials
NK Cell Therapy for Malignant Solid Brain Tumors
This is a multi-center, open-label investigator-initiated trial (IIT) designed to evaluate the safety, tolerability, and feasibility of combined intracranial and intravenous administration of ex vivo expanded and activated natural killer (NK) cells in adult patients with malignant solid brain tumors who have failed standard treatment modalities. The primary objective is to determine the maximum tolerated dose (MTD) or maximum feasible dose (MFD) of the combined NK cell therapy. Secondary objectives include preliminary assessment of anti-tumor activity as measured by progression-free survival (PFS), overall survival (OS), objective response rate (ORR) per RANO criteria, and evaluation of the immunological effects of NK cell infusion in the tumor microenvironment and peripheral blood.
Analysis of Cerebrospinal Fluid Leakage After Surgery for Intracranial Tumors
Cerebrospinal fluid is a clear fluid that surrounds and protects the brain. During surgery for brain tumors, neurosurgeons often need to open the covering of the brain (the dura) to reach the tumor. At the end of the operation, this covering is carefully closed again. In some cases, the closure might not be completely adequate leading to cerebrospinal fluid leak. This leakage may collect under the scalp or flow out through the surgical wound. When this happens, the surgical wound may not heal properly, and the risk of infection can increase. These complications can delay recovery and may postpone additional treatments, such as radiotherapy or chemotherapy, that are often needed after brain tumor surgery. Although cerebrospinal fluid leakage is less common after supratentorial craniotomy (surgery on the upper part of the brain) than after other types of brain surgery, it remains a challenging complication and has not been well studied in this group of patients. The aim of this study is to determine how often cerebrospinal fluid leakage occurs after supratentorial craniotomy for intracranial tumors, identify factors that increase the risk of leakage, and evaluate how these leaks are managed. Understanding these factors may help reduce the occurrence of cerebrospinal fluid leakage and improve postoperative recovery in the future.
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