APHP, Pitié-Salpêtrière Hospital, Nuclear Medicine Department, Sorbonne University, 75013 Paris, France.
INSERM, MMG, APHM, Timone Hospital, Neurosurgery Department, Aix-Marseille University, 13005 Marseille, France.
Curr Oncol. 2022 Aug 4;29(8):5550-5565. doi: 10.3390/curroncol29080438.
Somatostatin receptor (SSTR)-targeted peptide receptor radionuclide therapy (PRRT) represents a promising approach for treatment-refractory meningiomas progressing after surgery and radiotherapy. The aim of this study was to provide outcomes of patients harboring refractory meningiomas treated by 177Lu-DOTATATE and an overall analysis of progression-free survival at 6 months (PFS-6) of the same relevant studies in the literature. Eight patients with recurrent and progressive WHO grade II meningiomas were treated after multimodal pretreatment with 177Lu-DOTATATE between 2019 and 2022. Primary and secondarily endpoints were progression-free survival at 6-months (PFS-6) and toxicity, respectively. PFS-6 analysis of our case series was compared with other similar relevant studies that included 86 patients treated with either 177Lu-DOTATATE or 90Y-DOTATOC. Our retrospective study showed a PFS-6 of 85.7% for WHO grade II progressive refractory meningiomas. Treatment was clinically and biologically well tolerated. The overall analysis of the previous relevant studies showed a PFS-6 of 89.7% for WHO grade I meningiomas ( = 29); 57.1% for WHO grade II ( = 21); and 0 % for WHO grade III ( = 12). For all grades ( = 86), including unknown grades, PFS-6 was 58.1%. SSTR-targeted PRRT allowed us to achieve prolonged PFS-6 in patients with WHO grade I and II progressive refractory meningiomas, except the most aggressive WHO grade II tumors. Large scale randomized trials are warranted for the better integration of PRRT in the treatment of refractory meningioma into clinical practice guidelines.
生长抑素受体（SSTR）靶向肽受体放射性核素治疗（PRRT）代表了一种有前途的方法，可用于治疗手术后和放射治疗后进展的复发性脑膜瘤。本研究的目的是提供接受 177Lu-DOTATATE 治疗的难治性脑膜瘤患者的结果，并对文献中相同相关研究的 6 个月无进展生存（PFS-6）进行总体分析。2019 年至 2022 年期间，8 名复发性和进行性世卫组织 II 级脑膜瘤患者在多模态预处理后接受了 177Lu-DOTATATE 治疗。主要和次要终点分别是 6 个月时的无进展生存（PFS-6）和毒性。我们的病例系列 PFS-6 分析与其他包含 86 名接受 177Lu-DOTATATE 或 90Y-DOTATOC 治疗的类似相关研究进行了比较。我们的回顾性研究显示，世卫组织 II 级进展性难治性脑膜瘤的 PFS-6 为 85.7%。治疗在临床和生物学上均耐受良好。对以前相关研究的总体分析显示，世卫组织 I 级脑膜瘤的 PFS-6 为 89.7%（=29）；世卫组织 II 级脑膜瘤为 57.1%（=21）；世卫组织 III 级脑膜瘤为 0%（=12）。对于所有分级（=86），包括未知分级，PFS-6 为 58.1%。SSTR 靶向 PRRT 使我们能够在患有世卫组织 I 级和 II 级进展性难治性脑膜瘤的患者中实现延长的 PFS-6，除了最具侵袭性的世卫组织 II 级肿瘤。需要进行大规模的随机试验，以便更好地将 PRRT 整合到难治性脑膜瘤的治疗实践指南中。
