Recurrent high‑grade meningioma: a phase II trial with somatostatin analogue therapy
Purpose a prospective, two-stage phase II trial withoctreotide in patients with recurrent high-grade menin-gioma was conducted. the radiographic partial response(rPr) was set as the primary study endpoint, whereas pro-gression-free survival at 6 months(PFS6)was defined as the secondary endpoint.
Methods nine patients (eight men; median age 65) with histological high-grade meningioma (five with grade II and four with grade III) and progression after prior sur-gery and radiotherapy were included. all had positive brain octreotide SPeCt scanning. Octreotide was administered intramuscularly once every 28 days at a dose of 30 mg for the first two cycles and 40 mg for subsequent cycles until progression. Magnetic resonance imaging was performed every 3 months. Progression and rPr were defined as an increase of ≥25 % and as a decrease of ≥50 % in two-dimensional maximum diameters, respectively
.Results Patients received a median of three octreotide cycles (range 1–8) without grade ≥2 toxicities. no rPrswere observed. Stable disease was the best response in 33.3 % (n = 3). all patients had progressive disease at10 months of follow-up. Median time to progression was 4.23 months (range 1–9.4), and the PFS6 was 44.4 %(n = 4).
Conclusion Our study failed to provide evidence to sup-port the use of monthly long-acting somatostatin analogue schedule in recurrent high-grade meningiomas, as none of
our patients demonstrated rPr. the modest median PFS of 4–5 months along with the unknown natural history of recurrent meningiomas render the use of this therapy against these aggressive brain tumors uncertain.
Keywords High-grade meningioma · recurrent meningioma · Meningioma · Somatostatin · Octreotide