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Progression to a clinically aggressive meningioma is linked to inactivation of CDKN2A\/ B genes, and a plethora of signaling molecules have been described as activated in meningiomas, which supports the concept of successful clinical use of specific inhibitors. Established treatments include surgical resection with or without radiotherapy delivered in a single fraction, a few large fractions (radiosurgery), or multiple fractions (fractionated radiotherapy). For recurrent and aggressive tumors, inhibitors of the vascular endothelial growth factor (VEGF) pathway, such as vatalinib, bevacizumab, and sunitinib, showed signs of activity in small, uncontrolled studies, and prospective clinical studies will test the efficacy of the tetrahydroisoquinoline trabectedin and of SMO and AKT1 inhibitors.<\/jats:p>","DOI":"10.14694\/edbook_am.2015.35.e106","type":"journal-article","created":{"date-parts":[[2015,5,26]],"date-time":"2015-05-26T14:39:05Z","timestamp":1432651145000},"page":"e106-e115","source":"Crossref","is-referenced-by-count":27,"title":["Biology and Clinical Management Challenges in Meningioma"],"prefix":"10.1200","author":[{"given":"Christian","family":"Mawrin","sequence":"first","affiliation":[{"name":"From the Department of Neuropathology, Otto-von-Guericke University, Magdeburg, Germany; Department of Radiation Oncology, University of Toronto\/Princess Margaret Cancer Centre, Toronto, Canada; Department of Medicine I, Comprehensive 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