Recent advancements in meningioma treatment strategies have focused on systemic therapies and innovative surgical techniques. A phase II trial investigated the efficacy of GSK2256098, a focal adhesion kinase inhibitor, in patients with recurrent or progressive meningiomas, showing improved progression-free survival (PFS) rates (ref: Brastianos doi.org/10.1200/JCO.21.02371/). Additionally, a study by Jungwirth utilized a large-scale drug screening approach on FDA-approved drugs, identifying Ixabepilone, Romidepsin, Omacetaxine, and Carfilzomib as effective in reducing cell viability and promoting apoptosis in aggressive meningiomas (ref: Jungwirth doi.org/10.1158/1078-0432.CCR-22-2085/). Furthermore, Kumthekar's multi-institutional trial assessed bevacizumab's impact on various grades of meningiomas, revealing a potential therapeutic avenue for patients with limited options (ref: Kumthekar doi.org/10.1093/noajnl/). Kawamura's research highlighted the synergistic effects of histone deacetylase inhibitors with oncolytic herpes simplex virus therapy, suggesting a promising direction for treating malignant meningiomas (ref: Kawamura doi.org/10.1016/j.biopha.2022.113843/). Surgical strategies have also evolved, with Troude's study demonstrating the long-term benefits of a less aggressive resection strategy for large cerebellopontine angle meningiomas, achieving high tumor control rates (ref: Troude doi.org/10.3171/2022.8.JNS221329/).

The relationship between radiation exposure and meningioma risk has been a focal point of recent studies. Withrow's pooled analysis revealed a significant correlation between increased radiation doses and the likelihood of developing meningiomas, particularly noting that survivors exposed to doses of 24 Gy or more had over 30-fold higher odds of developing these tumors (ref: Withrow doi.org/10.1001/jamaoncol.2022.4425/). Razavian's investigation into stereotactic radiosurgery for radiation-induced meningiomas (RIMs) found that patients treated upfront had a markedly better PFS compared to those with recurrent RIMs, emphasizing the importance of early intervention (ref: Razavian doi.org/10.1007/s11060-022-04156-8/). Additionally, Lütgendorf-Caucig's study on the role of SSTR PET/CT in monitoring low-grade meningiomas post-proton therapy highlighted the potential of this imaging technique to enhance follow-up assessments (ref: Lütgendorf-Caucig doi.org/10.1007/s00066-022-02010-4/). These findings collectively underscore the critical need for careful monitoring of radiation exposure in patients, particularly children, who are at heightened risk for developing meningiomas.

The molecular and genetic landscape of meningiomas has been increasingly characterized, revealing distinct subgroups with varying clinical implications. Choudhury's study identified three DNA methylation subgroups in meningiomas, each associated with unique biological drivers and therapeutic vulnerabilities, thus paving the way for personalized treatment approaches (ref: Choudhury doi.org/10.1093/neuonc/). Di Bonaventura's research emphasized the prognostic significance of SOX2 expression in aggressive meningiomas, linking stemness features to tumor behavior and recurrence risk (ref: Di Bonaventura doi.org/10.3390/ijms231911690/). Furthermore, the expert consensus by Deng highlighted the evolving role of molecular diagnostics in meningioma classification, particularly following the WHO CNS5 updates, which stress the importance of integrating molecular data into clinical practice (ref: Deng doi.org/10.1097/CM9.0000000000002391/). Won's study on three-dimensional fractal analysis demonstrated its potential in predicting TERT promoter mutation status in grade 2 meningiomas, suggesting a novel non-invasive diagnostic tool (ref: Won doi.org/10.1371/journal.pone.0276342/). Collectively, these studies illustrate the importance of molecular characterization in guiding treatment decisions and improving patient outcomes.

Clinical outcomes and prognosis for meningioma patients have been extensively evaluated, particularly concerning treatment strategies and long-term survival. Pettersson-Segerlind's study provided crucial insights into the PFS and overall survival (OS) rates for WHO grade 2 and 3 meningiomas, reporting a median PFS of 31 months for grade 2 and only 3.4 months for grade 3 tumors, with median OS rates of 13 years and 1.4 years, respectively (ref: Pettersson-Segerlind doi.org/10.3390/cancers14205038/). Mederer's analysis of non-skull base meningiomas highlighted the significant improvement in neurological deficits following surgical resection, reinforcing the importance of timely intervention (ref: Mederer doi.org/10.3389/fonc.2022.967420/). The surgical limitations of the microscopic transciliary supraorbital keyhole approach were explored by Borghei-Razavi, providing valuable anatomical insights that could enhance surgical efficacy (ref: Borghei-Razavi doi.org/10.1016/j.wneu.2022.09.071/). Anita's work on deep learning architectures for meningioma detection and segmentation further emphasizes the role of technology in improving diagnostic accuracy and patient management (ref: Anita doi.org/10.15430/JCP.2022.27.3.192/). These findings collectively underscore the critical interplay between surgical techniques, clinical outcomes, and the integration of advanced technologies in managing meningiomas.

Innovative imaging techniques are transforming the diagnostic and prognostic landscape for meningiomas. Todic's study evaluated the prognostic significance of MRI findings in sudden sensorineural hearing loss, emphasizing the role of MRI in assessing intracranial pathologies (ref: Todic doi.org/10.1002/lio2.922/). Wu's research on terahertz time-domain spectroscopy demonstrated its potential in differentiating histological types and molecular features of gliomas, suggesting a novel approach to tumor characterization (ref: Wu doi.org/10.1016/j.saa.2022.121933/). Lütgendorf-Caucig's investigation into SSTR PET/CT's role in monitoring low-grade meningiomas post-treatment highlighted its utility in enhancing follow-up imaging protocols (ref: Lütgendorf-Caucig doi.org/10.1007/s00066-022-02010-4/). Park's proof of concept study on deep learning-based synthetic CT for Gamma Knife radiosurgery planning illustrated the potential of AI in improving treatment accuracy (ref: Park doi.org/10.1007/s13534-022-00227-x/). These studies collectively underscore the importance of integrating advanced imaging modalities into clinical practice to optimize diagnosis, treatment planning, and patient outcomes.

Surgical approaches and techniques for meningioma management have evolved significantly, focusing on optimizing outcomes while minimizing complications. Lee's study on Gamma Knife surgery (GKS) for benign meningiomas highlighted the importance of radiation dose management, identifying a critical threshold for achieving long-term local control while minimizing adverse effects (ref: Lee doi.org/10.3171/2022.8.JNS22422/). Borghei-Razavi's research into the microscopic transciliary supraorbital keyhole approach defined its surgical limitations, providing essential insights for improving access to anterior and middle cranial base pathologies (ref: Borghei-Razavi doi.org/10.1016/j.wneu.2022.09.071/). Xin's experience with three-dimensional endoscopes in transnasal skull base surgery demonstrated the benefits of enhanced visualization techniques, which can facilitate more precise tumor resections (ref: Xin doi.org/10.3389/fsurg.2022.996290/). The consensus statement on cavernous sinus meningiomas by Corniola emphasized the need for a multidisciplinary approach to manage these complex cases effectively (ref: Corniola doi.org/10.1016/j.bas.2022.100864/). Collectively, these studies illustrate the ongoing advancements in surgical techniques aimed at improving patient outcomes and reducing morbidity.

Epidemiological studies have provided critical insights into the incidence and characteristics of meningiomas. Ostrom's CBTRUS statistical report revealed an average annual age-adjusted incidence rate of 24.71 per 100,000 population for CNS tumors, with significant differences in survival rates between malignant and non-malignant cases (ref: Ostrom doi.org/10.1093/neuonc/). Endres developed a multicellular in vitro model to study the meningeal blood-CSF barrier, which could enhance understanding of meningioma pathogenesis and infection dynamics (ref: Endres doi.org/10.1186/s12987-022-00379-z/). Kawamura's research on histone deacetylase inhibitors in malignant meningiomas highlighted the need for targeted therapies in high-grade tumors, which are often associated with poor prognosis (ref: Kawamura doi.org/10.1016/j.biopha.2022.113843/). These findings underscore the importance of ongoing epidemiological research to inform clinical practices and improve patient outcomes.

The impact of external factors, including the COVID-19 pandemic, on meningioma management has been a recent area of investigation. Rubens' study analyzed hospitalization trends for intracranial meningioma resections, revealing a notable decrease in procedures during the pandemic, which raises concerns about delayed care and its implications for patient outcomes (ref: Rubens doi.org/10.3390/cancers14194785/). Lütgendorf-Caucig's research on SSTR PET/CT in the follow-up of low-grade meningiomas treated with proton therapy emphasized the importance of integrating advanced imaging techniques into routine care, particularly in the context of evolving treatment paradigms (ref: Lütgendorf-Caucig doi.org/10.1007/s00066-022-02010-4/). These studies highlight the need for adaptive strategies in clinical practice to mitigate the effects of external factors on patient care and treatment efficacy.