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Recurrent high-grade meningioma: a phase II trial with somatostatin analogue therapy

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Abstract

Purpose

A prospective, two-stage phase II trial with octreotide in patients with recurrent high-grade meningioma was conducted. The radiographic partial response (RPR) was set as the primary study endpoint, whereas progression-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 surgery 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 RPRs were observed. Stable disease was the best response in 33.3 % (n = 3). All patients had progressive disease at 10 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 support 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.

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Conflict of interest

We have no conflict of interest. No funding source had a role in the preparation of this paper or in the decision to submit it for publication.

Ethical standards

The protocol was approved by the clinical research ethics committees of the center, and the trial was conducted in accordance with the guidelines of the Spanish Ministry of Health and in accordance with good clinical practice and the tenets of the Declaration of Helsinki.

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Authors and Affiliations

  1. Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO Duran i Reynals and Institut de Diagnòstic per la Imatge, C/Feixa Llarga s/n, 08907, L’Hospitalet del Llobregat, Spain

    Marta Simó, Miquel Macià, Gerard Plans, Carles Majós, Noemi Vidal, Miguel Gil & Jordi Bruna

  2. Department of Neurology, Saint Andrew’s General Hospital of Patras, Patras, Greece

    Andreas A. Argyriou

  3. Centro de Investigación en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Cerdanyola del Vallès, Spain

    Carles Majós

Authors
  1. Marta Simó
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  2. Andreas A. Argyriou
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  3. Miquel Macià
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  4. Gerard Plans
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  7. Miguel Gil
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  8. Jordi Bruna
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Correspondence to Jordi Bruna.

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Simó, M., Argyriou, A.A., Macià, M. et al. Recurrent high-grade meningioma: a phase II trial with somatostatin analogue therapy. Cancer Chemother Pharmacol 73, 919–923 (2014). https://doi.org/10.1007/s00280-014-2422-z

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  • DOI: https://doi.org/10.1007/s00280-014-2422-z

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