The controversial role of Bevacizumab in the treatment of patients with intracranial meningioma: a comprehensive literature review

Introduction: Meningiomas represent the most common primary intracranial tumors. Today, surgical resection, followed by radiotherapy when indicated, is still the treatment of choice. In recent years, distinct oncogenic pathways have been identified, laying the foundations of new personalized targeted therapies. Areas covered: The aim of this study was to highlight the effects, complications, possible associations with other therapeutic approaches and multi-parametric outcome evaluation of Bevacizumab for the treatment of meningiomas. A literature review according to PRISMA criteria regarding the role of Bevacizumab for the treatment of various WHO grades of meningiomas was performed. 15 relevant papers, including 6 retrospective clinical trial series, 3 prospective trials, and 6 single patient case reports for a total of 134 patients and 211 meningiomas were include. Expert opinion: Because of the lack of strong clinical evidence about improved survival and related toxicity, the use of Bevacizumab for the treatment of meningiomas should be carefully evaluated. Further exploration, ideally with randomized controlled trials, is needed to better define the role of this drug in the treatment of meningiomas.