{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:21Z","timestamp":1788308241149,"version":"build-2803163510"},"reference-count":73,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:p>Meningiomas are the most common primary intracranial tumor and demonstrate marked heterogeneity in clinical behavior, ranging from indolent lesions cured by surgery to tumors characterized by early recurrence, treatment resistance, and neurological morbidity. The current WHO classification system, based predominantly on histopathological features with limited incorporation of molecular alterations, remains the global standard for grading. However, accumulating evidence indicates that WHO grade alone incompletely captures biological aggressiveness and risk of progression. Over the past decade, integrative molecular investigations, including genomic, transcriptomic, epigenetic, and copy number\u2013based analyses, have generated multiple independent classification schemas that more accurately stratify recurrence risk and clinical outcomes. Although these systems are not yet standardized or incorporated into formal WHO criteria, they consistently identify biologically distinct meningioma subgroups with clinically meaningful prognostic implications. This review synthesizes the current molecular classification landscape with a specific focus on its relevance to neurosurgical practice. We summarize key findings from single-omic and integrative studies, compare emerging schemas with traditional histopathological grading, and discuss how molecular risk stratification may influence surgical decision-making, surveillance strategies, and adjuvant therapy considerations. As molecular diagnostics become increasingly accessible, neurosurgeons will be confronted with this information in routine practice. A practical understanding of the strengths, limitations, and clinical implications for molecular diagnostics will be essential for optimizing the management of patients with aggressive meningiomas.<\/jats:p>","DOI":"10.3171\/2026.6.focus26253","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:56Z","timestamp":1787702456000},"page":"E9","source":"Crossref","is-referenced-by-count":0,"title":["Clinical perspectives for the practicing neurosurgeon on integrative multiomic analyses of aggressive meningiomas"],"prefix":"10.3171","volume":"61","author":[{"given":"Shree S.","family":"Pari","sequence":"first","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan M. J.","family":"Bauman","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangami","family":"Pugazenthi","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad M.","family":"Lak","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"},{"name":"Department of Neurosurgery, University of Iowa, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Shah","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Moynihan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya Linda","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhuvic","family":"Patel","sequence":"additional","affiliation":[{"name":"Taylor Family Department of Neurosurgery, WashU Medicine, St. Louis;"},{"name":"The Brain Tumor Center, Siteman Cancer Center, WashU Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"suppl 4","key":"b1","series-title":"Neuro Oncol","first-page":"iv1","article-title":"CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2018\u20132022","volume":"27","author":"Price M","year":"2025","unstructured":"Price M, Ballard CAP, Benedetti JR, Kruchko C, Barnholtz-Sloan JS, Ostrom QT. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2018\u20132022. Neuro Oncol. 2025;27(suppl 4):iv1\u2013iv66. doi:10.1093\/neuonc\/noaf194"},{"issue":"10","key":"b2","series-title":"Neuro Oncol","first-page":"1742","article-title":"Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients","volume":"26","author":"Wang JZ","year":"2024","unstructured":"Wang JZ, Landry AP, Raleigh DR,  Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients. Neuro Oncol. 2024;26(10):1742\u20131780. doi:10.1093\/neuonc\/noae082"},{"issue":"8","key":"b3","series-title":"Neuro Oncol","first-page":"1231","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary","volume":"23","author":"Louis DN","year":"2021","unstructured":"Louis DN, Perry A, Wesseling P,  The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021;23(8):1231\u20131251. doi:10.1093\/neuonc\/noab106"},{"issue":"5","key":"b4","series-title":"Lancet Oncol","first-page":"682","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"Sahm F","year":"2017","unstructured":"Sahm F, Schrimpf D, Stichel D,  DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. Lancet Oncol. 2017;18(5):682\u2013694. doi:10.1016\/S1470-2045(17)30155-9"},{"issue":"43","key":"b5","series-title":"Proc Natl Acad Sci U S A","first-page":"21715","article-title":"Molecular profiling predicts meningioma recurrence and reveals loss of DREAM complex repression in aggressive tumors","volume":"116","author":"Patel AJ","year":"2019","unstructured":"Patel AJ, Wan YW, Al-Ouran R,  Molecular profiling predicts meningioma recurrence and reveals loss of DREAM complex repression in aggressive tumors. Proc Natl Acad Sci U S A. 2019;116(43):21715\u201321726. doi:10.1073\/pnas.1912858116"},{"issue":"34","key":"b6","series-title":"J Clin Oncol","first-page":"3839","article-title":"Integrated molecular-morphologic meningioma classification: a multicenter retrospective analysis, retrospectively and prospectively validated","volume":"39","author":"Maas SLN","year":"2021","unstructured":"Maas SLN, Stichel D, Hielscher T,  Integrated molecular-morphologic meningioma classification: a multicenter retrospective analysis, retrospectively and prospectively validated. J Clin Oncol. 2021;39(34):3839\u20133852. doi:10.1200\/JCO.21.00784"},{"issue":"5","key":"b7","series-title":"Sci Adv","first-page":"eabm6247","article-title":"Multiple approaches converge on three biological subtypes of meningioma and extract new insights from published studies","volume":"8","author":"Bayley J","year":"2022","unstructured":"Bayley J, Hadley CC, Harmanci AO, Harmanci AS, Klisch TJ, Patel AJ. Multiple approaches converge on three biological subtypes of meningioma and extract new insights from published studies. Sci Adv. 2022;8(5):eabm6247. doi:10.1126\/sciadv.abm6247"},{"issue":"5","key":"b8","series-title":"Nat Genet","first-page":"649","article-title":"Meningioma DNA methylation groups identify biological drivers and therapeutic vulnerabilities","volume":"54","author":"Choudhury A","year":"2022","unstructured":"Choudhury A, Magill ST, Eaton CD,  Meningioma DNA methylation groups identify biological drivers and therapeutic vulnerabilities. Nat Genet. 2022;54(5):649\u2013659. doi:10.1038\/s41588-022-01061-8"},{"issue":"5","key":"b9","series-title":"Neuro Oncol","first-page":"796","article-title":"A molecularly integrated grade for meningioma","volume":"24","author":"Driver J","year":"2022","unstructured":"Driver J, Hoffman SE, Tavakol S,  A molecularly integrated grade for meningioma. Neuro Oncol. 2022;24(5):796\u2013808. doi:10.1093\/neuonc\/noab213"},{"issue":"2","key":"b10","series-title":"Nat Genet","first-page":"180","article-title":"Evidence for the complete inactivation of the NF2 gene in the majority of sporadic meningiomas","volume":"6","author":"Ruttledge MH","year":"1994","unstructured":"Ruttledge MH, Sarrazin J, Rangaratnam S,  Evidence for the complete inactivation of the NF2 gene in the majority of sporadic meningiomas. Nat Genet. 1994;6(2):180\u2013184. doi:10.1038\/ng0294-180"},{"issue":"6123","key":"b11","series-title":"Science","first-page":"1077","article-title":"Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO","volume":"339","author":"Clark VE","year":"2013","unstructured":"Clark VE, Erson-Omay EZ, Serin A,  Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science. 2013;339(6123):1077\u20131080. doi:10.1126\/science.1233009"},{"key":"b12","series-title":"NPJ Genom Med","first-page":"15","article-title":"Genomic landscape of high-grade meningiomas","volume":"2","author":"Bi WL","year":"2017","unstructured":"Bi WL, Greenwald NF, Abedalthagafi M,  Genomic landscape of high-grade meningiomas. NPJ Genom Med. 2017;2:15. doi:10.1038\/s41525-017-0014-7"},{"key":"b13","series-title":"Nat Commun","first-page":"14433","article-title":"Integrated genomic analyses of de novo pathways underlying atypical meningiomas","volume":"8","author":"Harmanc\u0131 AS","year":"2017","unstructured":"Harmanc\u0131 AS, Youngblood MW, Clark VE,  Integrated genomic analyses of de novo pathways underlying atypical meningiomas. Nat Commun. 2017;8:14433. doi:10.1038\/ncomms14433"},{"issue":"1","key":"b14","series-title":"Acta Neuropathol Commun","first-page":"171","article-title":"Distinct genomic subclasses of high-grade\/progressive meningiomas: NF2-associated, NF2-exclusive, and NF2-agnostic","volume":"8","author":"Williams EA","year":"2020","unstructured":"Williams EA, Santagata S, Wakimoto H,  Distinct genomic subclasses of high-grade\/progressive meningiomas: NF2-associated, NF2-exclusive, and NF2-agnostic. Acta Neuropathol Commun. 2020;8(1):171. doi:10.1186\/s40478-020-01040-2"},{"issue":"5","key":"b15","series-title":"J Neurosurg","first-page":"1345","article-title":"Correlations between genomic subgroup and clinical features in a cohort of more than 3000 meningiomas","volume":"133","author":"Youngblood MW","year":"2020","unstructured":"Youngblood MW, Duran D, Montejo JD,  Correlations between genomic subgroup and clinical features in a cohort of more than 3000 meningiomas. J Neurosurg. 2020;133(5):1345\u20131354. doi:10.3171\/2019.8.JNS191266"},{"issue":"5","key":"b16","series-title":"Oncogene","first-page":"875","article-title":"The spatial phenotype of genotypically distinct meningiomas demonstrate potential implications of the embryology of the meninges","volume":"40","author":"Fountain DM","year":"2021","unstructured":"Fountain DM, Smith MJ, O\u2019Leary C,  The spatial phenotype of genotypically distinct meningiomas demonstrate potential implications of the embryology of the meninges. Oncogene. 2021;40(5):875\u2013884. doi:10.1038\/s41388-020-01568-6"},{"issue":"2","key":"b17","series-title":"J Med Genet","first-page":"93","article-title":"Germline SMARCB1 mutation and somatic NF2 mutations in familial multiple meningiomas","volume":"48","author":"Christiaans I","year":"2011","unstructured":"Christiaans I, Kenter SB, Brink HC,  Germline SMARCB1 mutation and somatic NF2 mutations in familial multiple meningiomas. J Med Genet. 2011;48(2):93\u201397. doi:10.1136\/jmg.2010.082420"},{"issue":"3","key":"b18","series-title":"Nat Genet","first-page":"285","article-title":"Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations","volume":"45","author":"Brastianos PK","year":"2013","unstructured":"Brastianos PK, Horowitz PM, Santagata S,  Genomic sequencing of meningiomas identifies oncogenic SMO and AKT1 mutations. Nat Genet. 2013;45(3):285\u2013289. doi:10.1038\/ng.2526"},{"issue":"5","key":"b19","series-title":"Neuro Oncol","first-page":"783","article-title":"Associations of meningioma molecular subgroup and tumor recurrence","volume":"23","author":"Youngblood MW","year":"2021","unstructured":"Youngblood MW, Miyagishima DF, Jin L,  Associations of meningioma molecular subgroup and tumor recurrence. Neuro Oncol. 2021;23(5):783\u2013794. doi:10.1093\/neuonc\/noaa226"},{"issue":"5","key":"b20","series-title":"Neuro Oncol","first-page":"649","article-title":"Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma","volume":"18","author":"Abedalthagafi M","year":"2016","unstructured":"Abedalthagafi M, Bi WL, Aizer AA,  Oncogenic PI3K mutations are as common as AKT1 and SMO mutations in meningioma. Neuro Oncol. 2016;18(5):649\u2013655. doi:10.1093\/neuonc\/nov316"},{"issue":"10","key":"b21","series-title":"Nat Genet","first-page":"1253","article-title":"Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas","volume":"48","author":"Clark VE","year":"2016","unstructured":"Clark VE, Harmanc\u0131 AS, Bai H,  Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas. Nat Genet. 2016;48(10):1253\u20131259. doi:10.1038\/ng.3651"},{"issue":"4","key":"b22","series-title":"Hum Pathol","first-page":"416","article-title":"Telomerase activity in ordinary meningiomas predicts poor outcome","volume":"28","author":"Langford LA","year":"1997","unstructured":"Langford LA, Piatyszek MA, Xu R, Schold SC Jr, Wright WE, Shay JW. Telomerase activity in ordinary meningiomas predicts poor outcome. Hum Pathol. 1997;28(4):416\u2013420. doi:10.1016\/s0046-8177(97)90029-0"},{"issue":"10","key":"b23","series-title":"Cancer","first-page":"2092","article-title":"Implication of telomerase activity and alternations of telomere length in the histologic characteristics of intracranial meningiomas","volume":"89","author":"Chen HJ","year":"2000","unstructured":"Chen HJ, Liang CL, Lu K, Lin JW, Cho CL. Implication of telomerase activity and alternations of telomere length in the histologic characteristics of intracranial meningiomas. Cancer. 2000;89(10):2092\u20132098. doi:10.1002\/1097-0142(20001115)89:10<2092::AID-CNCR9>3.0.CO;2-N"},{"issue":"2","key":"b24","series-title":"Virchows Arch","first-page":"176","article-title":"Telomerase activity and expression of telomerase reverse transcriptase correlated with cell proliferation in meningiomas and malignant brain tumors in vivo","volume":"439","author":"Cabuy E","year":"2001","unstructured":"Cabuy E, de Ridder L. Telomerase activity and expression of telomerase reverse transcriptase correlated with cell proliferation in meningiomas and malignant brain tumors in vivo. Virchows Arch. 2001;439(2):176\u2013184. doi:10.1007\/s004280100466"},{"issue":"6","key":"b25","series-title":"Int J Mol Med","first-page":"943","article-title":"Telomerase in intracranial meningiomas","volume":"12","author":"Boldrini L","year":"2003","unstructured":"Boldrini L, Pistolesi S, Gisfredi S,  Telomerase in intracranial meningiomas. Int J Mol Med. 2003;12(6):943\u2013947. doi:10.3892\/ijmm.12.6.943"},{"issue":"2","key":"b26","series-title":"J Neurosurg","first-page":"303","article-title":"Prognostic value of allelic losses and telomerase activity in meningiomas","volume":"100","author":"Leuraud P","year":"2004","unstructured":"Leuraud P, Dezamis E, Aguirre-Cruz L,  Prognostic value of allelic losses and telomerase activity in meningiomas. J Neurosurg. 2004;100(2):303\u2013309. doi:10.3171\/jns.2004.100.2.0303"},{"issue":"2","key":"b27","series-title":"Brain Pathol","first-page":"184","article-title":"High incidence of activating TERT promoter mutations in meningiomas undergoing malignant progression","volume":"24","author":"Goutagny S","year":"2014","unstructured":"Goutagny S, Nault JC, Mallet M, Henin D, Rossi JZ, Kalamarides M. High incidence of activating TERT promoter mutations in meningiomas undergoing malignant progression. Brain Pathol. 2014;24(2):184\u2013189. doi:10.1111\/bpa.12110"},{"issue":"5","key":"b28","series-title":"J Natl Cancer Inst","first-page":"djv377","article-title":"TERT promoter mutations and risk of recurrence in meningioma","volume":"108","author":"Sahm F","year":"2016","unstructured":"Sahm F, Schrimpf D, Olar A,  TERT promoter mutations and risk of recurrence in meningioma. J Natl Cancer Inst. 2016;108(5):djv377. doi:10.1093\/jnci\/djv377"},{"issue":"9","key":"b29","series-title":"Lancet Oncol","first-page":"1178","article-title":"The effect of TERT promoter mutation on predicting meningioma outcomes: a multi-institutional cohort analysis","volume":"26","author":"Groff KJ","year":"2025","unstructured":"Groff KJ, Patel RV, Feng Y,  The effect of TERT promoter mutation on predicting meningioma outcomes: a multi-institutional cohort analysis. Lancet Oncol. 2025;26(9):1178\u20131190. doi:10.1016\/S1470-2045(25)00422-X"},{"issue":"9","key":"b30","series-title":"Lancet Oncol","first-page":"1191","article-title":"Analysis of TERT association with clinical outcome in meningiomas: a multi-institutional cohort study","volume":"26","author":"Gui C","year":"2025","unstructured":"Gui C, Wang JZ, Patil V,  Analysis of TERT association with clinical outcome in meningiomas: a multi-institutional cohort study. Lancet Oncol. 2025;26(9):1191\u20131203. doi:10.1016\/S1470-2045(25)00267-0"},{"issue":"2","key":"b31","series-title":"Brain Pathol","first-page":"183","article-title":"A role for chromosome 9p21 deletions in the malignant progression of meningiomas and the prognosis of anaplastic meningiomas","volume":"12","author":"Perry A","year":"2002","unstructured":"Perry A, Banerjee R, Lohse CM, Kleinschmidt-DeMasters BK, Scheithauer BW. A role for chromosome 9p21 deletions in the malignant progression of meningiomas and the prognosis of anaplastic meningiomas. Brain Pathol. 2002;12(2):183\u2013190. doi:10.1111\/j.1750-3639.2002.tb00433.x"},{"issue":"3","key":"b32","series-title":"Acta Neuropathol","first-page":"409","article-title":"CDKN2A\/B homozygous deletion is associated with early recurrence in meningiomas","volume":"140","author":"Sievers P","year":"2020","unstructured":"Sievers P, Hielscher T, Schrimpf D,  CDKN2A\/B homozygous deletion is associated with early recurrence in meningiomas. Acta Neuropathol. 2020;140(3):409\u2013413. doi:10.1007\/s00401-020-02188-w"},{"issue":"4","key":"b33","series-title":"Acta Neuropathol","first-page":"501","article-title":"Even heterozygous loss of CDKN2A\/B greatly accelerates recurrence in aggressive meningioma","volume":"145","author":"Khan AB","year":"2023","unstructured":"Khan AB, English CW, Chen WC,  Even heterozygous loss of CDKN2A\/B greatly accelerates recurrence in aggressive meningioma. Acta Neuropathol. 2023;145(4):501\u2013503. doi:10.1007\/s00401-023-02543-7"},{"issue":"5","key":"b34","series-title":"Neuro Oncol","first-page":"1209","article-title":"The prognostic impact of CDKN2A\/B hemizygous deletions in meningioma","volume":"28","author":"Ippen FM","year":"2026","unstructured":"Ippen FM, Hielscher T, Patel A,  The prognostic impact of CDKN2A\/B hemizygous deletions in meningioma. Neuro Oncol. 2026;28(5):1209\u20131219. doi:10.1093\/neuonc\/noag024"},{"issue":"7","key":"b35","series-title":"N Engl J Med","first-page":"722","article-title":"Chromosomal abnormalities in cancer","volume":"359","author":"Fr\u00f6hling S","year":"2008","unstructured":"Fr\u00f6hling S, D\u00f6hner H. Chromosomal abnormalities in cancer. N Engl J Med. 2008;359(7):722\u2013734. doi:10.1056\/NEJMra0803109"},{"issue":"3","key":"b36","series-title":"Exp Mol Pathol","first-page":"328","article-title":"Analysis of point mutations and copy number variation in Grade II and III meningioma","volume":"105","author":"McNulty SN","year":"2018","unstructured":"McNulty SN, Schwetye K, Goldstein M,  Analysis of point mutations and copy number variation in Grade II and III meningioma. Exp Mol Pathol. 2018;105(3):328\u2013333. doi:10.1016\/j.yexmp.2018.10.007"},{"issue":"1","key":"b37","series-title":"Nat Commun","first-page":"6025","article-title":"Distribution of copy number alterations and impact of chromosome arm call thresholds for meningioma","volume":"16","author":"Patel RV","year":"2025","unstructured":"Patel RV, Ghosh HS, Meredith DM,  Distribution of copy number alterations and impact of chromosome arm call thresholds for meningioma. Nat Commun. 2025;16(1):6025. doi:10.1038\/s41467-025-60734-0"},{"issue":"6","key":"b38","series-title":"JAMA Oncol","first-page":"644","article-title":"Chromosome 1p loss and 1q gain for grading of meningioma","volume":"11","author":"Landry AP","year":"2025","unstructured":"Landry AP, Wang JZ, Patil V,  Chromosome 1p loss and 1q gain for grading of meningioma. JAMA Oncol. 2025;11(6):644\u2013649. doi:10.1001\/jamaoncol.2025.0329"},{"issue":"2","key":"b39","series-title":"Neuro Oncol","first-page":"319","article-title":"cIMPACT-NOW update 8: clarifications on molecular risk parameters and recommendations for WHO grading of meningiomas","volume":"27","author":"Sahm F","year":"2025","unstructured":"Sahm F, Aldape KD, Brastianos PK,  cIMPACT-NOW update 8: clarifications on molecular risk parameters and recommendations for WHO grading of meningiomas. Neuro Oncol. 2025;27(2):319\u2013330. doi:10.1093\/neuonc\/noae170"},{"issue":"6","key":"b40","series-title":"Cell Genom","first-page":"100566","article-title":"Meningioma transcriptomic landscape demonstrates novel subtypes with regional associated biology and patient outcome","volume":"4","author":"Thirimanne HN","year":"2024","unstructured":"Thirimanne HN, Almiron-Bonnin D, Nuechterlein N,  Meningioma transcriptomic landscape demonstrates novel subtypes with regional associated biology and patient outcome. Cell Genom. 2024;4(6):100566. doi:10.1016\/j.xgen.2024.100566"},{"issue":"1","key":"b41","series-title":"Sci Rep","first-page":"18028","article-title":"Meta-gene markers predict meningioma recurrence with high accuracy","volume":"10","author":"Zador Z","year":"2020","unstructured":"Zador Z, Landry AP, Haibe-Kains B, Cusimano MD. Meta-gene markers predict meningioma recurrence with high accuracy. Sci Rep. 2020;10(1):18028. doi:10.1038\/s41598-020-74482-2"},{"issue":"1","key":"b42","series-title":"Acta Neuropathol","first-page":"145","article-title":"Increased mRNA expression of CDKN2A is a transcriptomic marker of clinically aggressive meningiomas","volume":"146","author":"Wang JZ","year":"2023","unstructured":"Wang JZ, Patil V, Liu J,  Increased mRNA expression of CDKN2A is a transcriptomic marker of clinically aggressive meningiomas. Acta Neuropathol. 2023;146(1):145\u2013162. doi:10.1007\/s00401-023-02571-3"},{"issue":"6","key":"b43","series-title":"J Natl Cancer Inst","first-page":"1175","article-title":"NF2 loss-of-function and hypoxia drive radiation resistance in grade 2 meningiomas","volume":"117","author":"Patel B","year":"2025","unstructured":"Patel B, Pugazenthi S, English CW,  NF2 loss-of-function and hypoxia drive radiation resistance in grade 2 meningiomas. J Natl Cancer Inst. 2025;117(6):1175\u20131187. doi:10.1093\/jnci\/djaf022"},{"issue":"12","key":"b44","series-title":"Nat Med","first-page":"3067","article-title":"Targeted gene expression profiling predicts meningioma outcomes and radiotherapy responses","volume":"29","author":"Chen WC","year":"2023","unstructured":"Chen WC, Choudhury A, Youngblood MW,  Targeted gene expression profiling predicts meningioma outcomes and radiotherapy responses. Nat Med. 2023;29(12):3067\u20133076. doi:10.1038\/s41591-023-02586-z"},{"issue":"1","key":"b45","series-title":"Genome Med","first-page":"49","article-title":"Single-cell profiling of human dura and meningioma reveals cellular meningeal landscape and insights into meningioma immune response","volume":"14","author":"Wang AZ","year":"2022","unstructured":"Wang AZ, Bowman-Kirigin JA, Desai R,  Single-cell profiling of human dura and meningioma reveals cellular meningeal landscape and insights into meningioma immune response. Genome Med. 2022;14(1):49. doi:10.1186\/s13073-022-01051-9"},{"issue":"1","key":"b46","series-title":"J Transl Med","first-page":"751","article-title":"Decoding meningioma heterogeneity and neoplastic cell-macrophage interaction through single-cell transcriptome profiling across pathological grades","volume":"21","author":"Fan H","year":"2023","unstructured":"Fan H, Song L, Fan J,  Decoding meningioma heterogeneity and neoplastic cell-macrophage interaction through single-cell transcriptome profiling across pathological grades. J Transl Med. 2023;21(1):751. doi:10.1186\/s12967-023-04445-4"},{"issue":"6","key":"b47","series-title":"Nat Genet","first-page":"1121","article-title":"Spatial genomic, biochemical and cellular mechanisms underlying meningioma heterogeneity and evolution","volume":"56","author":"Lucas C-HG","year":"2024","unstructured":"Lucas C-HG, Mirchia K, Seo K,  Spatial genomic, biochemical and cellular mechanisms underlying meningioma heterogeneity and evolution. Nat Genet. 2024;56(6):1121\u20131133. doi:10.1038\/s41588-024-01747-1"},{"issue":"10","key":"b48","series-title":"Cancer Discov","first-page":"1823","article-title":"Perivascular NOTCH3+ stem cells drive meningioma tumorigenesis and resistance to radiotherapy","volume":"14","author":"Choudhury A","year":"2024","unstructured":"Choudhury A, Cady MA, Lucas C-HG,  Perivascular NOTCH3+ stem cells drive meningioma tumorigenesis and resistance to radiotherapy. Cancer Discov. 2024;14(10):1823\u20131837. doi:10.1158\/2159-8290.CD-23-1459"},{"issue":"7697","key":"b49","series-title":"Nature","first-page":"469","article-title":"DNA methylation-based classification of central nervous system tumours","volume":"555","author":"Capper D","year":"2018","unstructured":"Capper D, Jones DTW, Sill M,  DNA methylation-based classification of central nervous system tumours. Nature. 2018;555(7697):469\u2013474. doi:10.1038\/nature26000"},{"issue":"1","key":"b50","series-title":"Neurooncol Adv","first-page":"vdae228","article-title":"cIMPACT-NOW update 9: recommendations on utilization of genome-wide DNA methylation profiling for central nervous system tumor diagnostics","volume":"7","author":"Aldape K","year":"2025","unstructured":"Aldape K, Capper D, von Deimling A,  cIMPACT-NOW update 9: recommendations on utilization of genome-wide DNA methylation profiling for central nervous system tumor diagnostics. Neurooncol Adv. 2025;7(1):vdae228. doi:10.1093\/noajnl\/vdae228"},{"issue":"16","key":"b51","series-title":"Cancer Res","first-page":"7121","article-title":"Integrative genomic analysis identifies NDRG2 as a candidate tumor suppressor gene frequently inactivated in clinically aggressive meningioma","volume":"65","author":"Lusis EA","year":"2005","unstructured":"Lusis EA, Watson MA, Chicoine MR,  Integrative genomic analysis identifies NDRG2 as a candidate tumor suppressor gene frequently inactivated in clinically aggressive meningioma. Cancer Res. 2005;65(16):7121\u20137126. doi:10.1158\/0008-5472.CAN-05-0043"},{"issue":"3","key":"b52","series-title":"J Neurooncol","first-page":"533","article-title":"uPA\/PAI-1 expression and uPA promoter methylation in meningiomas","volume":"103","author":"Kandenwein JA","year":"2011","unstructured":"Kandenwein JA, Park-Simon TW, Schramm J, Simon M. uPA\/PAI-1 expression and uPA promoter methylation in meningiomas. J Neurooncol. 2011;103(3):533\u2013539. doi:10.1007\/s11060-010-0411-6"},{"issue":"10","key":"b53","series-title":"J Neuropathol Exp Neurol","first-page":"882","article-title":"Genetic alterations associated with progression and recurrence in meningiomas","volume":"71","author":"P\u00e9rez-Mag\u00e1n E","year":"2012","unstructured":"P\u00e9rez-Mag\u00e1n E, Campos-Mart\u00edn Y, Mur P,  Genetic alterations associated with progression and recurrence in meningiomas. J Neuropathol Exp Neurol. 2012;71(10):882\u2013893. doi:10.1097\/NEN.0b013e31826bf704"},{"issue":"1","key":"b54","series-title":"PLoS One","first-page":"e54114","article-title":"DNA methylation in the malignant transformation of meningiomas","volume":"8","author":"Gao F","year":"2013","unstructured":"Gao F, Shi L, Russin J,  DNA methylation in the malignant transformation of meningiomas. PLoS One. 2013;8(1):e54114. doi:10.1371\/journal.pone.0054114"},{"issue":"4","key":"b55","series-title":"PLoS One","first-page":"e94987","article-title":"Molecular biological determinations of meningioma progression and recurrence","volume":"9","author":"Linsler S","year":"2014","unstructured":"Linsler S, Kraemer D, Driess C,  Molecular biological determinations of meningioma progression and recurrence. PLoS One. 2014;9(4):e94987. doi:10.1371\/journal.pone.0094987"},{"issue":"3","key":"b56","series-title":"Acta Neuropathol","first-page":"431","article-title":"Global epigenetic profiling identifies methylation subgroups associated with recurrence-free survival in meningioma","volume":"133","author":"Olar A","year":"2017","unstructured":"Olar A, Wani KM, Wilson CD,  Global epigenetic profiling identifies methylation subgroups associated with recurrence-free survival in meningioma. Acta Neuropathol. 2017;133(3):431\u2013444. doi:10.1007\/s00401-017-1678-x"},{"issue":"7","key":"b57","series-title":"Neuro Oncol","first-page":"901","article-title":"DNA methylation profiling to predict recurrence risk in meningioma: development and validation of a nomogram to optimize clinical management","volume":"21","author":"Nassiri F","year":"2019","unstructured":"Nassiri F, Mamatjan Y, Suppiah S,  DNA methylation profiling to predict recurrence risk in meningioma: development and validation of a nomogram to optimize clinical management. Neuro Oncol. 2019;21(7):901\u2013910. doi:10.1093\/neuonc\/noz061"},{"issue":"4","key":"b58","series-title":"Neuro Oncol","first-page":"1004","article-title":"Validation and next-generation update of a DNA methylation\u2013based recurrence predictor for meningioma: a multicenter prospective study","volume":"27","author":"Landry AP","year":"2025","unstructured":"Landry AP, Wang JZ, Patil V,  Validation and next-generation update of a DNA methylation\u2013based recurrence predictor for meningioma: a multicenter prospective study. Neuro Oncol. 2025;27(4):1004\u20131016. doi:10.1093\/neuonc\/noae236"},{"issue":"2","key":"b59","series-title":"J Neurooncol","first-page":"405","article-title":"The multiomic landscape of meningiomas: a review and update","volume":"161","author":"Wang JZ","year":"2023","unstructured":"Wang JZ, Nassiri F, Landry AP,  The multiomic landscape of meningiomas: a review and update. J Neurooncol. 2023;161(2):405\u2013414. doi:10.1007\/s11060-023-04253-2"},{"issue":"1","key":"b60","series-title":"Nat Commun","first-page":"4803","article-title":"Multiplatform genomic profiling and magnetic resonance imaging identify mechanisms underlying intratumor heterogeneity in meningioma","volume":"11","author":"Magill ST","year":"2020","unstructured":"Magill ST, Vasudevan HN, Seo K,  Multiplatform genomic profiling and magnetic resonance imaging identify mechanisms underlying intratumor heterogeneity in meningioma. Nat Commun. 2020;11(1):4803. doi:10.1038\/s41467-020-18582-7"},{"issue":"11","key":"b61","series-title":"Cancer Discov","first-page":"1722","article-title":"The meningioma enhancer landscape delineates novel subgroups and drives druggable dependencies","volume":"10","author":"Prager BC","year":"2020","unstructured":"Prager BC, Vasudevan HN, Dixit D,  The meningioma enhancer landscape delineates novel subgroups and drives druggable dependencies. Cancer Discov. 2020;10(11):1722\u20131741. doi:10.1158\/2159-8290.CD-20-0160"},{"issue":"7874","key":"b62","series-title":"Nature","first-page":"119","article-title":"A clinically applicable integrative molecular classification of meningiomas","volume":"597","author":"Nassiri F","year":"2021","unstructured":"Nassiri F, Liu J, Patil V,  A clinically applicable integrative molecular classification of meningiomas. Nature. 2021;597(7874):119\u2013125. doi:10.1038\/s41586-021-03850-3"},{"issue":"5","key":"b63","series-title":"Neuro Oncol","first-page":"1258","article-title":"Development and validation of a molecular classifier of meningiomas","volume":"27","author":"Landry AP","year":"2025","unstructured":"Landry AP, Wang JZ, Liu J,  Development and validation of a molecular classifier of meningiomas. Neuro Oncol. 2025;27(5):1258\u20131269. doi:10.1093\/neuonc\/noae242"},{"issue":"3","key":"b64","series-title":"Neuro Oncol","first-page":"520","article-title":"Hypermitotic meningiomas harbor DNA methylation subgroups with distinct biological and clinical features","volume":"25","author":"Choudhury A","year":"2023","unstructured":"Choudhury A, Chen WC, Lucas CHG,  Hypermitotic meningiomas harbor DNA methylation subgroups with distinct biological and clinical features. Neuro Oncol. 2023;25(3):520\u2013530. doi:10.1093\/neuonc\/noac224"},{"issue":"2","key":"b65","series-title":"Nat Genet","first-page":"341","article-title":"A microenvironment-determined risk continuum refines subtyping in meningioma and reveals determinants of machine learning-based tumor classification","volume":"58","author":"Maas SLN","year":"2026","unstructured":"Maas SLN, Tang Y, Stutheit-Zhao E,  A microenvironment-determined risk continuum refines subtyping in meningioma and reveals determinants of machine learning-based tumor classification. Nat Genet. 2026;58(2):341\u2013354. doi:10.1038\/s41588-025-02475-w"},{"issue":"43","key":"b66","series-title":"Sci Adv","first-page":"eadn4419","article-title":"Multiomic and clinical analysis of multiply recurrent meningiomas reveals risk factors, underlying biology, and insights into evolution","volume":"10","author":"Pugazenthi S","year":"2024","unstructured":"Pugazenthi S, Patel B, English CW,  Multiomic and clinical analysis of multiply recurrent meningiomas reveals risk factors, underlying biology, and insights into evolution. Sci Adv. 2024;10(43):eadn4419. doi:10.1126\/sciadv.adn4419"},{"issue":"11","key":"b67","series-title":"Nat Med","first-page":"3173","article-title":"Molecular classification to refine surgical and radiotherapeutic decision-making in meningioma","volume":"30","author":"Wang JZ","year":"2024","unstructured":"Wang JZ, Patil V, Landry AP,  Molecular classification to refine surgical and radiotherapeutic decision-making in meningioma. Nat Med. 2024;30(11):3173\u20133183. doi:10.1038\/s41591-024-03167-4"},{"issue":"8","key":"b68","series-title":"Neuro Oncol","first-page":"2047","article-title":"Metabolic profiling of meningioma reveals novel subgroup-specific biologic insights and outcome dependencies","volume":"27","author":"Landry AP","year":"2025","unstructured":"Landry AP, Wang JZ, Yefet LS,  Metabolic profiling of meningioma reveals novel subgroup-specific biologic insights and outcome dependencies. Neuro Oncol. 2025;27(8):2047\u20132059. doi:10.1093\/neuonc\/noae281"},{"issue":"22","key":"b69","series-title":"Cancers (Basel)","first-page":"3665","article-title":"MRI reflects meningioma biology and molecular risk","volume":"17","author":"Canisius J","year":"2025","unstructured":"Canisius J, Schuler J, Goldberg M,  MRI reflects meningioma biology and molecular risk. Cancers (Basel). 2025;17(22):3665. doi:10.3390\/cancers17223665"},{"issue":"1","key":"b70","series-title":"Nat Commun","first-page":"5669","article-title":"Detection of diagnostic and prognostic methylation-based signatures in liquid biopsy specimens from patients with meningiomas","volume":"14","author":"Herrgott GA","year":"2023","unstructured":"Herrgott GA, Snyder JM, She R,  Detection of diagnostic and prognostic methylation-based signatures in liquid biopsy specimens from patients with meningiomas. Nat Commun. 2023;14(1):5669. doi:10.1038\/s41467-023-41434-z"},{"issue":"8","key":"b71","series-title":"Neuro Oncol","first-page":"2035","article-title":"ROBIN: a unified nanopore-based assay integrating intraoperative methylome classification and next-day comprehensive profiling for ultra-rapid tumor diagnosis","volume":"27","author":"Deacon S","year":"2025","unstructured":"Deacon S, Cahyani I, Holmes N,  ROBIN: a unified nanopore-based assay integrating intraoperative methylome classification and next-day comprehensive profiling for ultra-rapid tumor diagnosis. Neuro Oncol. 2025;27(8):2035\u20132046. doi:10.1093\/neuonc\/noaf103"},{"key":"b72","series-title":"Comput Struct Biotechnol J","first-page":"51","article-title":"Rapid intraoperative amplicon sequencing of CNS tumor markers","volume":"26","author":"Evers M","year":"2024","unstructured":"Evers M, Br\u00e4ndl B, Rohrandt C,  Rapid intraoperative amplicon sequencing of CNS tumor markers. Comput Struct Biotechnol J. 2024;26:51\u201357. doi:10.1016\/j.csbj.2024.11.007"},{"issue":"2","key":"b73","series-title":"Neuro Oncol","first-page":"430","article-title":"A framework for using DNA methylation-based modelling for the clinical management of cranial meningioma","volume":"28","author":"Landry AP","year":"2026","unstructured":"Landry AP, Wang JZ, Patil V,  A framework for using DNA methylation-based modelling for the clinical management of cranial meningioma. Neuro Oncol. 2026;28(2):430\u2013439. doi:10.1093\/neuonc\/noaf237"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/3\/article-pE9.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/3\/article-pE9.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/3\/article-pE9.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:01:08Z","timestamp":1788307268000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/3\/article-pE9.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":73,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2026.6.focus26253","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}