In a 2008 review of atypical and anaplastic-meningiomas by Yang et al, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. Mean relapse-free survival for atypical meningiomas was 11.5 years vs. 2.7 years for anaplastic meningiomas. Meningiomas are often vascularized tumors and and it is reasonable to consider antiangiogenic therapy for meningioma. In particular, malignant meningiomas produce high levels of vascular endothelial growth factor (VEGF) and the Avastin blocks this growth factor. It would make sense that Avastin should be effective. However, agressive and anaplastic meningiomas are rare and there is little known about what works and what does not work for it. Chamberlain found that temozolamide appears ineffective for refractory meningioma. 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.
Norden AD, Drappatz J, Wen PY. Advances in meningioma therapy.Curr Neurol Neurosci Rep. 2009 May;9(3):231-40.
Yang SY et al.: Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J Neurol Neurosurg Psychiatry. 2008 May;79(5):574-80.
S. Goutagny et al, Radiographic regression of cranial meningioma in a NF2 patient treated by bevacizumab Ann Oncol (2011) 22(4): 990-991
Chamberlain MC, Tsao-Wei DD, Groshen S. Temozolomide for treatment-resistant recurrent meningioma.Neurology. 2004 Apr 13;62(7):1210-2.
Newton HB. Hydroxyurea chemotherapy in the treatment of meningiomas. Neurosurg Focus. 2007;23(4):E11.
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