Somatostatin receptor–targeted radiopeptide therapy in treatment-refractory meningioma: Individual patient data meta-analysis

C Mirian, AK Duun-Henriksen, A Maier… - Journal of Nuclear …, 2021 - Soc Nuclear Med
C Mirian, AK Duun-Henriksen, A Maier, MM Pedersen, LR Jensen, A Bashir, T Graillon…
Journal of Nuclear Medicine, 2021Soc Nuclear Med
Somatostatin receptor (SSTR)–targeted peptide receptor radionuclide therapy (PRRT)
represents a promising approach for treatment-refractory meningiomas. Methods: We
performed an individual patient data meta-analysis, including all published data on
meningioma patients treated with SSTR-targeted PRRT. The 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 …
Somatostatin receptor (SSTR)–targeted peptide receptor radionuclide therapy (PRRT) represents a promising approach for treatment-refractory meningiomas.
Methods
We performed an individual patient data meta-analysis, including all published data on meningioma patients treated with SSTR-targeted PRRT. The 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 6 eligible cohort studies. We included a total of 111 patients who had treatment-refractory meningioma and received SSTR-targeted PRRT. Disease control was achieved in 63% of patients. The 6-mo PFS rates were 94%, 48%, and 0% for World Health Organization grades I, II, and III, respectively. The risk of disease progression decreased by 13% per 1,000-MBq increase in the total applied activity. The 1-y OS rates were 88%, 71%, and 52% for World Health Organization grades I, II, and III, respectively. The risk of death decreased by 17% per 1,000-MBq increase in the total applied activity. The main side effects comprised transient hematotoxicity, such as anemia in 22% of patients, leukopenia in 13%, lymphocytopenia in 24%, and thrombocytopenia in 17%.
Conclusion
To our knowledge, this individual patient data meta-analysis represents the most comprehensive analysis of the benefits of and adverse events associated with SSTR-targeted PRRT for treatment-refractory meningioma. The treatment was well tolerated, achieved disease control in most cases, and showed promising results regarding PFS and OS.
Society of Nuclear Medicine and Molecular Imaging
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