Dimitrios Roukas1, Stylianos Mastronikolis2, Evangelos Tsiambas3,6,9, Despoina Spyropoulou4, Ioannis Stavrakis5, Vasileios Ragos6, Pavlos Pantos7, Anastasios Kouzoupis8, Nikolaos Kavantzas9, Andreas Lazaris9**

1Department of Psychiatry, 417 VA (NIMTS) Hospital, Athens, Greece;

2Medical School, University of Heraklion, Crete;

3Department of Cytology, 417 VA (NIMTS) Hospital, Athens, Greece;

4Department of Radiology, Medical School, University of Patras;

5ENT Department, ‘’Sotiria’’ General Hospital, Athens, Greece;

6Department of Maxillofacial Surgery, Medical School, University of Ioannina, Greece;

71ST ENT Department, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece;

8Department of Psychiatry, Medical School, University of Athens, Greece;

9Department of Pathology, Medical School, University of Athens, Greece

*These authors contributed equally to this work

Meningiomas are the second most common brain tumors and the most common intracranial primary central nervous system (CNS) tumors in adults. Recurrence of these tumors, especially in higher-grade meningiomas, is correlated with aggressive biological behavior affecting the response rates to surgery/radiation applied therapeutic regimens. Caspases (cysteine-aspartic proteases) represent a family of enzymes that modify several functions crucial for cell homeostasis such as inflammation and apoptosis. According to their implication in the apoptotic pathways, caspases are characterized as initiators and executioners, respectively. All these normal actions of the caspase complex that induce apoptosis are altered in epithelial malignancies. In cancerous tissues, programmed cell death is inhibited due to deregulation in the expression of apo- and anti-apoptotic proteins. This genetic imbalance drives the cancer cell to immortalization, reflecting aberrant tissue proliferation. For this reason, caspases and other apoptotic molecules are considered important targets for specific targeted therapeutic strategies enhancing the apoptotic levels of tumor cells. In the current review, we explore the role of caspase modifications in meningiomas and their potential impact as biomarkers and targets for applying specific therapeutic strategies in the corresponding tumors.

Key words: apoptosis, meningioma, caspase, targeted therapies, brain.

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