Treatment of Cerebral Meningioma in WHO Grade 3 (Anaplastic) Presentation

WHO grade 3 anaplastic meningioma represents the most aggressive end of the meningioma spectrum. This subtype is associated with rapid growth, a high likelihood of early recurrence, and a risk of systemic metastasis — alongside distinct molecular features at the genetic and epigenetic level.

Clinical Scenario

This protocol applies to patients with cerebral meningioma classified at WHO grade 3 (anaplastic). These tumors are characterized by rapid growth, early recurrence, risk of systemic metastasis, and particular molecular features on genetic and epigenetic levels, making management substantially more complex than lower-grade disease.

Treatment Approach

When no further local treatment option remains available, systemic salvage pharmacotherapy may be considered. The approach involves targeted antiangiogenic or multikinase inhibitor strategies — the specific selection, sequencing, and application criteria are detailed in the full protocol.

Full regimen details, eligibility criteria, and clinical decision logic are available in the structured protocol below.