Background: Meningiomas are the second most prevalent adult central nervous system neoplasm, developing from arachnoid cap cells. While most are benign (WHO Grade I), atypical (Grade II), and anaplastic (Grade III), meningiomas portray aggressive behavior, higher relapse rates, and resistance to standard treatments. Objective: To study the progression of treatment strategies for meningiomas, underscoring emerging treatments and challenges, especially in recurrent and high-grade subtypes. Methods: A narrative review was conducted, identifying studies from the PubMed, Scopus, and Google Scholar databases (2000–2025). Keywords included “meningioma,” “surgery,” “radiotherapy,” “targeted therapy,” “immunotherapy,” and “PRRT.” Included studies addressed conventional or novel treatments for meningiomas. Results: Surgical resection continues as the gold standard, with the extent of removal impacting recurrence. Radiotherapy, comprising fractionated and stereotactic techniques, plays a vital role when surgery is incomplete or not possible. Chemotherapy demonstrates limited benefit. Advances in molecular profiling have shown genetic drivers (e.g., NF2, TRAF7, AKT1) and hormonal receptors as clinical targets. Emerging options include mTOR inhibitors (everolimus), anti-angiogenic agents (bevacizumab), PD-1/PD-L1 inhibitors (pembrolizumab), and peptide receptor radionuclide therapy (PRRT). Drug delivery treatments like convection-improved delivery show promise in improving CNS penetration. Nonetheless, resistance mechanisms, the absence of validated biomarkers, and insufficient trial data pose significant challenges. Conclusion: Management of severe aggressive meningiomas is evolving with novel molecular and immunotherapeutic strategies. A multidisciplinary treatment strategy combining surgery, radiation, and targeted therapies, facilitated by further clinical trials and biomarker research, is necessary to enhance patient outcomes.

Purpose: Chemotherapy-induced neutropenia (CIN) is a common complication that increases the risk of infection, hospitalization, and treatment delays. While granulocyte colony-stimulating factors (G-CSFs) like filgrastim and pegfilgrastim are used to reduce these risks, limitations in dosing schedules and variability remain. Efbemalenograstim alfa (F-627), a novel long-acting recombinant G-CSF, has emerged as a potential alternative. This systematic review and meta-analysis aimed to evaluate its comparative safety and efficacy against standard G-CSFs in patients undergoing chemotherapy for non-myeloid malignancies. Methods: A comprehensive literature search was conducted across six databases for randomised controlled trials (RCTs) comparing F-627 to standard G-CSFs. Data from three active-controlled trials were pooled using Review Manager (RevMan) 5.4.1, with results expressed as risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes. Heterogeneity was assessed using the I² statistic. Narrative synthesis was performed for the data in the placebo-controlled trial and outcomes with insufficient data for meta-analysis. Risk of bias and evidence quality were evaluated using the Cochrane RoB 2.0 tool and GRADE guidelines, respectively. Results: Four RCTs comprising 973 patients were included, with 533 receiving F-627. F-627 showed comparable efficacy to standard G-CSFs in reducing duration of Grade 4 neutropenia in cycle 1 (MD = 0.04 days; 95% CI: − 0.04 to 0.13; I² = 0%). Incidence of severe neutropenia and febrile neutropenia were also similar (RR = 1.02; 95% CI: 0.97–1.07 and RR = 1.33; 95% CI: 0.41–4.30, respectively). However, a placebo-controlled trial showed a significant reduction in neutropenia and febrile neutropenia incidence with F-627. Secondary outcomes and adverse event profiles were broadly comparable across treatment arms. Conclusion Efbemalenograstim alfa offers a comparable safety and efficacy profile to standard G-CSFs for the prevention of CIN, supporting its role as a viable therapeutic option in non-myeloid cancers.