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Significance Meningiomas are the most common primary brain tumors. Although most of these tumors are benign, one-fifth will recur despite apparently complete resection. Several studies have demonstrated that genomic approaches can yield important insights into the biology of these tumors. We performed RNA sequencing and whole-exome sequencing of 160 tumors from 140 patients, which identified 3 distinct groups of meningioma that correlate with recurrence better than the current World Health Organization grading system. Our analysis also revealed that the most aggressive type was characterized by loss of the repressive DREAM complex. These findings should improve prognostication for patients and lead to viable therapeutic targets.

Molecular profiling predicts meningioma recurrence and reveals loss of DREAM complex repression in aggressive tumors