AUTHORS: Mirian C, Duun-Henriksen AK, Maier A, Møller Pedersen M, Rehné Jensen L, Bashir A, Graillon T, Hrachova M, Bota D, van Essen M, Spanjol P, Kreis C, Law I, Broholm H, Poulsgaard L, Fugleholm K, Ziebell M, Munch T, Walter MA, and Mathiesen T

Journal of Nuclear Medicine, : , August 2020

ABSTRACT

Background:

Somatostatin receptor (SSTR)-targeted peptide receptor radionuclide therapy (PRRT) represents a promising approach for treatment-refractory meningiomas.

Methods:

We performed an individual patient data (IPD) meta-analysis including all published meningioma patients treated with SSTR-targeted PRRT. Main outcomes were toxicity, response to treatment, progression-free survival (PFS), and overall survival (OS). We applied the Kaplan-Meier method to estimate survival probabilities and report incidence rates per 100 person-years. We applied Cox proportional hazards models to determine the effect of covariates.

Results:

We screened 537 papers, and identified six eligible cohort studies. We included a total of 111 patients with treatment-refractory meningioma who received SSTR-targeted PRRT. Disease control was achieved in 63% of patients. Six-month PFS was 94%, 48% and 0% for WHO (World Health Organization)-I, -II, & -III, respectively. The risk of disease progression decreased by 13% per 1000 MBq increase in the total applied activity. One-year OS was 88%, 71%, and 52% for WHO-I, -II & -III, respectively. The risk of death decreased by 17% per 1000-MBq increase of the total applied activity. Main side effects comprised transient hematotoxicities such as anemia in 22%, leukopenia in 13%, lymphocytopenia in 24%, and thrombocytopenia in 17% of patients.

Conclusion:

This IPD meta-analysis represents the most comprehensive analysis of benefits and adverse events of SSTR-targeted PRRT for treatment-refractory meningioma. The treatment was well tolerated, achieved disease control in most cases, and showed promising PFS and OS.

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