May 30, 2025
Multiplatform molecular data is shedding new light on brain tumor heterogeneity. Mayo Clinic is at the forefront of applying the latest discoveries to patient care.
"Genomic, methylation and other testing is transforming our approach to brain tumor treatment. We can use molecular profiling to individualize care for each patient," says Gelareh Zadeh, M.D., Ph.D., chair of Neurosurgery at Mayo Clinic in Rochester, Minnesota.
As a major quaternary center, Mayo Clinic has the resources to rapidly provide a treatment plan for every patient. "We can determine what molecular tests are most suitable and create a personalized treatment plan, from diagnosis through surgery, radiation, chemotherapy and follow-up," Dr. Zadeh says. "We are committed to providing an opinion within 48 hours for patients with primary brain tumors, brain metastases, and pituitary and skull base tumors."
Mayo Clinic's multidisciplinary Brain Tumor Program offers an integrated care model. "As a group, we discuss every case to decide what treatment options are the best for the patient," Dr. Zadeh says. A specialist in meningioma care, Dr. Zadeh has developed algorithms that use information about tumor genetic alterations to predict brain tumor behavior, including the risk of brain metastasis or recurrence and the tumor's response to radiation.
Cutting-edge research applied to patient care
Molecular testing results help predict tumor behavior. "This information can determine whether a patient would need surgery, how aggressively we should pursue surgical resection and whether postsurgical radiation is indicated," Dr. Zadeh says. "We can also use these biomarkers to identify any changes in tumor growth over time to predict recurrence early."
Meningiomas are a particular focus of these efforts. Although the most common primary brain tumors in adults, meningiomas have been under-studied. Dr. Zadeh co-founded the International Consortium on Meningiomas (ICOM), a group of 59 institutions working to identify the best guidelines for care.
In a study published in Nature Medicine, ICOM researchers identified molecular predictors of treatment response to meningiomas. The researchers characterized the benefits of differential degrees of tumor resection and dural margin treatment across different molecular classifications and also identified a group of molecularly defined radiotherapy-resistant meningiomas.
"These findings have the potential to meaningfully impact clinical decision-making and patient selection in today's molecular era of meningioma management," Dr. Zadeh says.
Other research has used DNA methylation profiling to predict brain metastases from lung adenocarcinomas. "We now have clinically relevant classifications and outcome prediction tools using methylation testing for all brain tumors," Dr. Zadeh says.
Mayo Clinic always seeks to translate laboratory studies into patient care. "The motivation behind our research is always to maximize patient outcomes and allow patients to make better informed decisions about their brain tumor care," Dr. Zadeh says.
For more information
Brain Tumor Program. Mayo Clinic.
Wang JZ, et al. Molecular classification to refine surgical and radiotherapeutic decision-making in meningioma. Nature Medicine. 2024;30:3173.
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