Journal of Neuro-Oncology, Meningioma issue

Meningiomas are one of the most common types of brain tumors and frequently encountered by neurosurgeons, neuro-oncologists and radiation oncologists alike. Some meningiomas may never become symptomatic, while others can become quite debilitating to patients based on their location, size and mass effect on and/or involvement of critical neurovascular structures. While these tumors are more often histologically benign, a subset can behave more aggressively with higher rates of recurrence. Moreover, some low grade meningiomas can also behave more aggressively with higher rates of anticipated recurrence. Thus, for certain “histologically benign” tumors, their clinical behavior may be anything but benign.

Recently, tremendous scientific advances have been made to better understand the molecular biology of meningiomas. Indeed, we now have a more in-depth understanding of the genetic and epigenetic alterations driving formation and growth of these tumors, classifying them into molecular subgroups, with insight into why some transform into more malignant tumors and recur, while others do not. More recent observations from translational research have underscored the difficulty with treatment of these tumors at the biological level and has identified specific genomic changes that suggest options for treatment. These findings can ultimately influence the management of meningiomas, both upfront and at the time of recurrence. To that end, precision medicine with care personalized to each individual is important. Clinical trials are showing promise in the potential use of newer drug therapies for progressive and recurrent meningiomas.

Given the prevalence and potential complexity of meningiomas, this dedicated issue provides a comprehensive overview of the multidisciplinary management of meningiomas.

The Editors wish to dedicate their work in editing this special addition to our sons, Aydin Gunel and Leonidas Brastianos Els. They are the joys of our lives and the meaning behind all that we strive to do to care for our patients.

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