Most meningiomas are slow and benign, but a small subset can be aggressive and ahs agressive pathological features. In a 2008 review of the aggressive types, atypical and anaplastic-meningiomas, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. Meningiomas often depend and blood vessels and and it is reasonable to consider anti blood vessel therapy for meningioma. In particular, malignant meningiomas produce high levels of vascular endothelial growth factor (VEGF) and it would make sense that Avastin should be effective, because it blocks this factor. However, agressive and anaplastic meningiomas are rare and there is little known about what works and what does not work for it. Temodar appears ineffective for refractory meningioma, but hydroxyurea is more promising.
Angiogenesis inhibitors, progestins, agents that target fundamental cell signaling pathways, somatostatin analogues, and a variety of other molecular treatments are being investigated.
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