Impact of TERT and CDKN2A/B driver mutations on meningioma recurrence: a systematic review and meta-analysis

Authors:

Глеб Сергеевич Сергеев,

Михаил Васильевич Нестерчук,

Владимир Сергеевич Климов,

Алексей Сергеевич Гайтан,

Владислав Владимирович Куфтов,

Глеб Валерьевич Данилов,

Николай Александрович Коновалов,

Дмитрий Юрьевич Усачев,

Алексей Леонидович Кривошапкин

Журнал: Вопросы нейрохирургии имени Н.Н. Бурденко. 2026;90(5):76-89.

DOI: 10.17116/neiro20269005176

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Abstract

BACKGROUND

Evolution of the WHO classification for meningiomas demonstrates a shift towards integrative approach, where molecular markers are essential for risk stratification. However, their prognostic significance depending on histological grade requires further clarification.

OBJECTIVE

To evaluate the impact of TERT promoter mutations and CDKN2A/B deletions on meningioma recurrence, stratified by tumor grade.

MATERIAL AND METHODS

A systematic review and meta-analysis (PRISMA-P) of 17 cohort studies (n=5867) was conducted. Random-effect models and network meta-analysis were employed to assess overall survival (OS) and progression-free survival (PFS).

RESULTS

The TERT mutation significantly worsens prognosis (OS HR=2.78; PFS HR=2.63), but the effect is context-dependent. In WHO Grade 1–2 tumors, it acts as a potent driver of aggression (HR~5.00, “initiation effect”), whereas in Grade 3 its contribution diminishes (HR~1.5) amidst general genomic instability. Homozygous deletion of CDKN2A/B is confirmed as a universal marker of early recurrence (HR=3.72) with up to 5-fold risk increment. Sensitivity analysis revealed that clonal mutations (detected by Sanger sequencing) hold greater prognostic value than subclonal ones (detected by NGS).

CONCLUSION

TERT screening is essential for WHO Grade 1 and 2 meningiomas to identify occult aggression, while CDKN2A/B assessment is a priority for Grade 3 tumors.

Keywords

meningioma recurrence
TERT promoter mutation
CDKN2A/B homozygous deletion
driver mutations

Конфликт интересов

The authors declare no conflicts of interest.

Дата поступления: 20.03.2026

Дата принятия в печать: 20.07.2026

Дата публикации: 16.10.2026

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