Correlation between bevacizumab therapy in meningioma and tissutal biomarkers of response

Meningioma is the most common primary central nervous system tumor. The majority of meningiomas present with a non-aggressive behaviour, but a fraction of them relapses repetitively and determines increased morbidity and mortality. The standard treatment of symptomatic meningioma is surgical resection, aimed at achieving gross total resection followed by radiotherapy, when indicated. No preferred standard of care is available for systemic therapies in case of relapse/recurrence or unresectable disease, not eligible for surgery and/or radiotherapy; a variety of therapies has been studied, with controversial results. Meningiomas have historically been systemically treated with hydroxyurea, but recent data have shown promising results supporting the use of bevacizumab in this setting. So far no biomarkers to select and personalize treatment for patients are available in clinical practice. Based on such knowledge, a retrospective study comparing hydroxyurea and bevacizumab in recurrent meningioma, previously treated with surgery and radiotherapy, was conducted. Tissutal molecular data were collected and analyzed to investigate possible biomarkers of response to treatment.