Review Advances Precision Care Pathway for Meningioma Management

Meningiomas are the most common primary brain tumors and account for about 37% of central nervous system tumors, often impairing neurological function depending on where they arise. Care has traditionally relied on microscopic appearance, which can make individualized decisions about recurrence risk and treatment challenging. A new review now demonstrates a precision-oncology pathway that integrates molecular, imaging, and clinical information to enable more patient-centered care.

Mayo Clinic led a comprehensive review in Nature Reviews Clinical Oncology that maps a modern, multidisciplinary approach to meningioma management. The work emphasizes tailoring decisions to each patient by combining tumor biology, advanced imaging, and clinical context. It highlights a shift away from one-size-fits-all strategies toward frameworks that support diagnosis, surveillance, and treatment aligned with individual risk.

The review identifies several technology-enabled advances. Molecular classification systems are improving prognostication by distinguishing tumors more likely to grow or recur, thereby informing earlier, targeted interventions. Advanced imaging, including PET/MRI, supports earlier detection of residual or returning disease to guide timely therapy. Surgical refinements and precision radiotherapy techniques aim to reduce complications while preserving neurological function.

Traditionally, treatment decisions have been guided by tumor appearance under a microscope. The review highlights a shift toward integrating molecular, imaging, and clinical data to individualize care. The authors describe a treatment pathway that spans active surveillance, used to avoid unnecessary intervention and preserve quality of life, to minimally invasive surgery and highly targeted radiation when treatment is required.

For aggressive or recurrent disease, emerging options such as targeted therapies, immunotherapy, and radioligand treatments are increasingly selected based on molecular profiling and advanced imaging. Together, these approaches illustrate how combining multimodal data can optimize outcomes while reducing overtreatment.

Published in Nature Reviews Clinical Oncology on April 13, the review draws on global expertise and is intended to support care teams as they translate rapidly evolving science into practice. According to the summary, the overarching direction is toward more personalized, timely treatment tailored to each patient’s tumor characteristics and clinical status.

“This work synthesizes rapidly evolving science to support more personalized care for patients with meningioma. With insights and technologies emerging quickly, there is an urgent need to translate new knowledge into clinical practice. This review helps care teams make more informed decisions to improve outcomes and quality of life for patients,” said Gelareh Zadeh, M.D., Ph.D., chair of the Department of Neurologic Surgery at Mayo Clinic in Rochester and senior author of the review.

“This is about redefining how we care for patients with the most common type of brain tumor. It moves us beyond a one-size-fits-all approach toward more personalized care,” said Dr. Zadeh.

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