BIOM-75. FOXM1 AND KI-67 PREDICT POOR PROGNOSIS IN GRADE II AND III MENINGIOMA PATIENTS

Abstract Meningioma exhibits significant and wide-ranging recurrence rates across all WHO grades, reported at 7-25% (Grade I), 29-59% (Grade II), and 50-94% (Grade III). Although current literature has identified several potential molecular biomarkers to assess the risk of meningioma recurrence, there is a lack of consensus in their prognostic reliability. Further classifying biomarkers according to the tumor’s histological grade can help address this variability and improve their prognostic power. We aim to identify dependable molecular biomarkers, stratified by WHO grade, that can accurately predict the risk of meningioma recurrence. A meta-analysis was conducted following PRISMA guidelines, searching across the PubMed, Web of Science, Cochrane, Embase, and Scopes databases for studies that investigated meningioma biomarkers. Screening and data extraction of included literature was conducted using the Covidence manager. The variables of interest included the tumor’s WHO grade, the investigated molecular biomarker, and the associated meningioma recurrence rate. 607 patients were included, consisting of 67.7% females and 32.3% males. The average age was 44.6 yrs ± 8.7 (range: 29 - 68 yrs). Our data showed that a Ki-67 index of > 20% was significantly associated with atypical (WHO II) meningiomas recurrence (p<0.003). In addition, FOXM1 was found significantly upregulated in malignant (WHO III) meningiomas (p=0.012) with a significantly higher rate of recurrence (p=0.004). These findings suggest that Ki-67 and FOXM1 are promising molecular biomarkers to determine the likelihood of meningioma recurrence in WHO grade II and III tumors respectively. Our data found a Ki-67 index greater than 20% and an upregulation of FOXM1 as prevalent indicators of poor prognosis, both of which could serve as indices of increased meningioma recurrence and future therapeutic targets.