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Efficacy and safety of peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE in 15 patients with progressive treatment-refractory meningioma

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Abstract

Purpose

There is no evidence-based systemic therapy for patients with progressive meningiomas for whom surgery or external radiotherapy is no longer an option. In this study, the efficacy and safety of peptide receptor radionuclide therapy (PRRT) in patients with progressive, treatment-refractory meningiomas were evaluated.

Methods

Retrospective analysis of all meningioma patients treated with [177Lu]Lu-DOTA-TATE from 2000 to 2020 in our centre. Primary outcomes were response according to RANO bidimensional and volumetric criteria and progression-free survival (PFS). Overall survival (OS) and tumour growth rate (TGR) were secondary endpoints. TGR was calculated as the percentage change in surface or volume per month.

Results

Fifteen meningioma patients received [177Lu]Lu-DOTA-TATE (7.5–29.6 GBq). Prior to PRRT, all patients had received external radiotherapy, and 14 patients had undergone surgery. All WHO grades were included WHO 1 (n=3), WHO 2 (n=5), and WHO 3 (n=6). After PRRT, stable disease was observed in six (40%) patients. The median PFS was 7.8 months with a 6-month PFS rate of 60%. The median OS was 13.6 months with a 12-month OS rate of 60%. All patients had progressive disease prior to PRRT, with an average TGR of 4.6% increase in surface and 14.8% increase in volume per month. After PRRT, TGR declined to 3.1% in surface (p=0.016) and 5.0% in volume (p=0.013) per month.

Conclusion

In this cohort of meningioma patients with exhaustion of surgical and radiotherapeutic options and progressive disease, it was shown that PRRT plays a role in controlling tumour growth.

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Endocrinology, ENETS Centre of Excellence Rotterdam, Erasmus MC and Erasmus MC Cancer Institute, Rotterdam, The Netherlands

    Noémie S. Minczeles, Wouter W. de Herder & Johannes Hofland

  2. Department of Radiology & Nuclear Medicine, ENETS Centre of Excellence Rotterdam, Erasmus MC, Rotterdam, The Netherlands

    Noémie S. Minczeles, Reinoud C. de Leeuw, Mark W. Konijnenberg & Tessa Brabander

  3. Department of Neurosurgery, Erasmus MC, Rotterdam, The Netherlands

    Eelke M. Bos & Clemens M. F. Dirven

  4. Department of Pathology, ENETS Centre of Excellence Rotterdam, Erasmus MC, Rotterdam, The Netherlands

    Johan M. Kros

  5. Department of Neurology, Erasmus MC, Rotterdam, The Netherlands

    Jacoline E. C. Bromberg

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  1. Noémie S. Minczeles
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Contributions

Concept and design: NSM, EMB, JECB, JH, and TB

Acquisition, analysis, and/or interpretation of data: all authors

Drafting of the manuscript: NSM

Critical revision of the manuscript for important intellectual content: all authors

Statistical analysis: NSM, JH, and TB.

Corresponding author

Correspondence to Noémie S. Minczeles.

Ethics declarations

Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Erasmus Medical Centre.

Consent to participate

Informed consent was obtained from all subjects involved in the study, or the need for written informed consent was waived by the medical ethical committee of the Erasmus MC.

Consent for publication

Informed consent was obtained from all subjects involved in the study, or the need for written informed consent was waived by the medical ethical committee of the Erasmus MC.

Conflict of interest

E.M.B has received consultancy fees from BrainLab A.G. W.W.D.H has received speaker fees from AAA-Novartis and Ipsen, compensation from AAA-Novartis and Ipsen for service on advisory boards, and research support from AAA-Novartis. J.H. has received speaker fees from Ipsen and compensation from AAA-Novartis and Ipsen for service on advisory boards. T.B. has received speaker fees from AAA-Novartis and Ipsen, compensation from AAA-Novartis for service on advisory board, and research support from AAA-Novartis. The other authors have no disclosures.

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Eelke M. Bos and Reinoud C. de Leeuw shared second authorship.

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Minczeles, N.S., Bos, E.M., de Leeuw, R.C. et al. Efficacy and safety of peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE in 15 patients with progressive treatment-refractory meningioma. Eur J Nucl Med Mol Imaging 50, 1195–1204 (2023). https://doi.org/10.1007/s00259-022-06044-9

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