Table 3.
Biomarkers of meningiomas with different locations and WHO grades.
| Tumor location | WHO grade | Recommendation grade I | Recommendation grade II | Recommendation grade III | Adjuvant therapy |
| Midline anterior and central skull base | Grade 1 | AKT1, PIK3CA, SMO, SUFU, TRAF7, H3K27me3, SSTR2 | VEGFR | POLR2A | Everolimus-octreotide (SSTR2, AKT1, PI3K), bevacizumab (VEGFR) |
| Grade 2 | AKT1, PIK3CA, SMO, SUFU, TRAF7, BAP1, H3K27me3, SSTR2 | VEGFR | – | Everolimus-octreotide (SSTR2, AKT1, PI3K), bevacizumab (VEGFR) | |
| Grade 3 | TERTp, CDKN2A/B, AKT1, PIK3CA, SMO, SUFU, TRAF7, BAP1, H3K27me3, SSTR2 | VEGFR | – | Everolimus-octreotide (SSTR2, AKT1, PI3K), bevacizumab (VEGFR) | |
| Non-midline anterior and central skull base | Grade 1 | KLF4, H3K27me3, SSTR2 | VEGFR | – | Everolimus-octreotide (SSTR2), bevacizumab (VEGFR) |
| Grade 2 | KLF4, BAP1, H3K27me3, SSTR2 | VEGFR | – | Everolimus-octreotide (SSTR2), bevacizumab (VEGFR) | |
| Grade 3 | TERTp, CDKN2A/B, KLF4, BAP1, H3K27me3, SSTR2 | VEGFR | – | Everolimus-octreotide (SSTR2), bevacizumab (VEGFR) | |
| Convexity | Grade 1 | 22q, NF2, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) |
| Grade 2 | 22q, NF2, BAP1, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) | |
| Grade 3 | 22q, NF2, TERTp, CDKN2A/B, BAP1, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) | |
| Spine | Grade 1 | 22q, NF2, SMARCE1, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) |
| Grade 2 | 22q, NF2, BAP1, SMARCE1, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) | |
| Grade 3 | 22q, NF2, TERTp, CDKN2A/B, BAP1, SMARCE1, H3K27me3, SSTR2 | VEGFR | – | Sunitinib (22q), everolimus-octreotide (SSTR2), bevacizumab (VEGFR) |
AKT1: Protein kinase B; BAP1: BRCA1 associated protein 1; CDKN2A/B: cyclin-dependent kinase inhibitor 2A/B; H3K27me3: Trimethylation of lysine 27 on histone 3; KLF4: Krüppel-like factor 4; NF2: Neurofibromin 2; PI3K: Phosphosphatidylinositol-3-kinase; PIK3CA: Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha isoform; POLR2A: RNA polymerase II; SMARCE1: SWI/SNF Related, matrix associated, actin dependent regulator of chromatin, subfamily E, member 1; SMO: Smoothened; SUFU: Suppressor of fused homolog; SSTR2: Somatostatin receptor 2; TERT: Telomerase reverse transcriptase; TERTp: Telomerase reverse transcriptase promoter; TRAF7: Tumor necrosis factor receptor associated factor 7; VEGFR: Vascular endothelial growth factor receptor; -: Not available.