New Treatments & Clinical Trials for Meningioma

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.

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.