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01-09-2018 | Clinical Study

Effect of lapatinib on meningioma growth in adults with neurofibromatosis type 2

Authors: Diana S. Osorio, Jessica Hu, Carole Mitchell, Jeffrey C. Allen, Joseph Stanek, Mari Hagiwara, Matthias A. Karajannis

Published in: Journal of Neuro-Oncology | Issue 3/2018

Abstract

Introduction

Epidermal growth factor receptors EGFR and ErbB2 are overexpressed in schwannomas and meningiomas. Preclinical and clinical data indicate that lapatinib, an EGFR/ErbB2 inhibitor, has antitumor activity against vestibular schwannomas in neurofibromatosis type 2 (NF2) patients. Its antitumor activity against meningiomas, however, is unknown.

Methods

We conducted a retrospective review of patients with NF2 and progressive vestibular schwannomas treated on a phase 2 clinical trial with lapatinib (NCT00973739). We included patients with at least one volumetrically measurable meningioma (> 0.5 cm³) who received at least five 28-day courses of treatment. Patients received lapatinib 1500 mg daily. Meningioma response was assessed using 3-dimensional MRI volumetrics. Progressive meningioma growth and response were defined as + 20 and − 20% change in tumor volume from baseline, respectively. Off-treatment was defined as any period > 5 months without lapatinib.

Results

Eight patients (ages: 20–58 years) who met criteria had 17 evaluable meningiomas with a combined volume of 61.35 cc at baseline, 61.17 cc during treatment, and 108.86 cc (+ 77.44% change) off-treatment, p = 0.0033. Median time on-treatment and off-treatment was 15.5 and 16.7 months, respectively. On-treatment mean and median annualized growth rates were 10.67 and 1.32%, respectively. Off-treatment mean and median annualized growth rates were 20.05 and 10.42%, respectively. The best volumetric response was − 26.1% after 23 months on lapatinib. Two tumors increased > 20% volumetrically on-treatment, compared to eight tumors off-treatment.

Conclusions

These data suggest that lapatinib may have growth-inhibitory effects on meningiomas in NF2 patients, and support prospective studies of lapatinib for NF2 patients with progressive meningiomas.

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Title: Effect of lapatinib on meningioma growth in adults with neurofibromatosis type 2
Authors: Diana S. Osorio
Jessica Hu
Carole Mitchell
Jeffrey C. Allen
Joseph Stanek
Mari Hagiwara
Matthias A. Karajannis
Publication date: 01-09-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2922-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of lapatinib on meningioma growth in adults with neurofibromatosis type 2

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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