Table 4.

Details of some common immunomodulators used in target therapy for the treatment of meningioma

Drug name	Drug composition/molecular formula administration			Mechanism of Action	Type of study		Reference
Immunomodulators
IFN Α2b		C16H17Cl3I2N3NaO5S	Antiproliferative and antiangiogenic properties			Phase II: mixed results		[118]
Nivolumab		It is a human IgG4 monoclonal antibody, intravenously	It works as a checkpoint inhibitor; T cells kill cancer cells and protect our body from cancer; in turn, cancer cells develop proteins to defend themselves against T lymphocytes; nivolumab inhibits the protective proteins in T lymphocytes, causing them to attack cancer cells; the protein PD-1 is found on the surface of activated T lymphocytes. T cells become inactive when another molecule termed programmed cell death 1 ligand 1 or programmed cell death 1 ligand 2 binds to PD-1; this anticancer drug works by preventing PD-L1/2 from attaching to PD-1, allowing T lymphocytes to destroy cancer cells			Outside of the respiratory epithelium and placental tissue, PD-L1 is expressed in 40–50% of melanomas and has low expression in most visceral organs; PD-1 receptor and ligand inhibitor; phase II		[69]
Pembrolizumab		It is an immunoglobulin G4, intravenous injection	It is an immune checkpoint inhibitor like nivolumab; its mechanism of action is similar to nivolumab, which treats melanoma, head and neck cancer, lung cancer, Hodgkin lymphoma, and stomach cancer; under normal conditions, T cells interact with other cells through PD-1 and PD-L1 or PD-L2; PD-1 receptors present on the activated T-cell bind to ligands PD-L1 or PD-L2 on other cells and deactivate the T-cell-mediated immune response; in this way, the body prevents the immune system from acting on normal cells; in many cancers, cells make protein PD-L1 that binds PD-1, thus shutting down the ability of the body to kill cancer cells; pembrolizumab inhibits the binding of PD-1 on lymphocytes to PD-L1 and PD-L2 on cancer cells, thereby allowing lymphocytes to destroy cancer cells			Pembrolizumab affects meningioma cell growth; PD-1 receptor and ligand, Inhibitor; phase II		[69]
Avelumab		It is a human monoclonal antibody of isotype IgG1, intravenous infusion	Its working mechanism is the same as that of pembrolizumab and nivolumab			Avelumab is used for the treatment of Merkel cell carcinoma, urothelial carcinoma, and renal cell carcinoma (Fig. 3); PD-1 receptor and ligand inhibitor; phase II		[119]