Implications and interchangeability of meningioma biomarkers for clinical trials and clinical practice

Excerpt

There has been a revolution in meningioma biomarker development over the last 11 years that has followed the central dogma of molecular biology, yielding both prognostic and predictive biomarkers. Starting with the identification of recurrent DNA mutations that are enriched in meningiomas with favorable clinical outcomes and that correlate with location at the skull base [1], and more recently culminating in a targeted gene expression risk score that predicts sensitivity to postoperative radiotherapy [2], these discoveries have shed new light on biological drivers and therapeutic vulnerabilities for the most common primary intracranial tumor. DNA and RNA biomarkers, alongside DNA methylation profiling [3, 4] and integrated systems that incorporate multiple molecular features [5, 6], have created a framework for redefining clinical paradigms for patients with meningiomas, and clinical trials are beginning to incorporate meningioma biomarkers to identify patients who may be most likely to benefit from existing, repurposed, or novel therapeutics. As we await results from these prospective studies, many investigators are curious to know which of the myriad meningioma biomarkers are most accurate, and whether multiple biomarker systems are truly needed to better characterize a tumor that is commonly considered benign. …