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Research ArticleTheranostics

Somatostatin Receptor–Targeted Radiopeptide Therapy in Treatment-Refractory Meningioma: Individual Patient Data Meta-analysis

Christian Mirian, Anne Katrine Duun-Henriksen, Andrea Maier, Maria Møller Pedersen, Lasse Rehné Jensen, Asma Bashir, Thomas Graillon, Maya Hrachova, Daniela Bota, Martjin van Essen, Petar Spanjol, Christian Kreis, Ian Law, Helle Broholm, Lars Poulsgaard, Kåre Fugleholm, Morten Ziebell, Tina Munch, Martin A. Walter and Tiit Mathiesen
Journal of Nuclear Medicine April 2021, 62 (4) 507-513; DOI: https://doi.org/10.2967/jnumed.120.249607
Christian Mirian
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
2Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
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Anne Katrine Duun-Henriksen
3Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
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Andrea Maier
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Maria Møller Pedersen
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Lasse Rehné Jensen
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Asma Bashir
4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Copenhagen, Denmark
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Thomas Graillon
5APHM, Department of Neurosurgery, La Timone Hospital, Marseille, France
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Maya Hrachova
6Department of Neurology, UC Irvine Medical Center, Irvine, California
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Daniela Bota
6Department of Neurology, UC Irvine Medical Center, Irvine, California
7Department of Neurosurgery, UC Irvine Medical Center, Irvine, California
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Martjin van Essen
8Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Petar Spanjol
2Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
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Christian Kreis
2Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
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Ian Law
4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Copenhagen, Denmark
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Helle Broholm
9Department of Neuropathology, Copenhagen University Hospital, Copenhagen, Denmark
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Lars Poulsgaard
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Kåre Fugleholm
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
10Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Morten Ziebell
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Tina Munch
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
10Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
11Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; and
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Martin A. Walter
2Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
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Tiit Mathiesen
1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
10Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
12Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Abstract

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.

  • treatment-refractory meningioma
  • progressive meningioma
  • peptide receptor radionuclide therapy
  • somatostatin receptor

Footnotes

  • ↵* Contributed equally to this work.

  • Published online Aug. 28, 2020.

  • © 2021 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 62 (4)
Journal of Nuclear Medicine
Vol. 62, Issue 4
April 1, 2021
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Somatostatin Receptor–Targeted Radiopeptide Therapy in Treatment-Refractory Meningioma: Individual Patient Data Meta-analysis
Christian Mirian, Anne Katrine Duun-Henriksen, Andrea Maier, Maria Møller Pedersen, Lasse Rehné Jensen, Asma Bashir, Thomas Graillon, Maya Hrachova, Daniela Bota, Martjin van Essen, Petar Spanjol, Christian Kreis, Ian Law, Helle Broholm, Lars Poulsgaard, Kåre Fugleholm, Morten Ziebell, Tina Munch, Martin A. Walter, Tiit Mathiesen
Journal of Nuclear Medicine Apr 2021, 62 (4) 507-513; DOI: 10.2967/jnumed.120.249607

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Somatostatin Receptor–Targeted Radiopeptide Therapy in Treatment-Refractory Meningioma: Individual Patient Data Meta-analysis
Christian Mirian, Anne Katrine Duun-Henriksen, Andrea Maier, Maria Møller Pedersen, Lasse Rehné Jensen, Asma Bashir, Thomas Graillon, Maya Hrachova, Daniela Bota, Martjin van Essen, Petar Spanjol, Christian Kreis, Ian Law, Helle Broholm, Lars Poulsgaard, Kåre Fugleholm, Morten Ziebell, Tina Munch, Martin A. Walter, Tiit Mathiesen
Journal of Nuclear Medicine Apr 2021, 62 (4) 507-513; DOI: 10.2967/jnumed.120.249607
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Keywords

  • treatment-refractory meningioma
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  • Peptide receptor radionuclide therapy
  • somatostatin receptor
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