Peptide receptor radionuclide therapy in patients with inoperable meningiomas: our experience and review of the literature

Cancer Biother Radiopharm. 2014 Jun;29(5):193-9. doi: 10.1089/cbr.2013.1599. Epub 2014 May 8.

Abstract

Objective: Few studies describe peptide receptor radionuclide therapy (PRRT) using (90)Y- or (177)Lu-labeled peptides in patients with recurrent meningiomas. No clinical data about (111)In-Pentetreotide in such patients are available. We report on (111)In-Pentetreotide therapy in patients with inoperable meningiomas and review the literature about PRRT of meningiomas.

Methods: We reviewed clinical records of 8 patients with meningioma/meningiomatosis showing high (111)In-Pentetreotide uptake on pretherapy scintigraphy who were treated with at least one cycle of (111)In-Pentetreotide. In 2 patients, a cocktail of (111)In-Pentetreotide and beta-emitting radiolabeled peptides had been administered.

Results: No patient experienced acute toxicity, neurological or renal function impairment. Mild transient bone marrow toxicity was observed in 4 patients. Objective partial response was observed in 2 patients, stable disease in 5 and disease progression in one. There were no statistically significant correlations between objective response and patient age, tumor WHO grade, baseline Karnofsky performance score, (111)In-Pentetreotide tumoral uptake grade, tumor/nontumor ratio, disease state at baseline, and cumulative dose.

Conclusions: In consideration of its efficacy and the lack of significant toxicity, PRRT of meningiomas using (111)In-Pentetreotide could be proposed even nowadays when the use of (177)Lu- or (90)Y-labeled peptides seems unsafe, namely in patients with renal impairment/toxicity.

Keywords: 111In-Pentetreotide; meningioma; peptide receptor radionuclide therapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Indium Radioisotopes / adverse effects
  • Indium Radioisotopes / pharmacokinetics
  • Indium Radioisotopes / therapeutic use*
  • Male
  • Meningeal Neoplasms / metabolism
  • Meningeal Neoplasms / radiotherapy*
  • Meningioma / metabolism
  • Meningioma / radiotherapy*
  • Middle Aged
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / pharmacokinetics
  • Radiopharmaceuticals / therapeutic use*
  • Receptors, Peptide
  • Retrospective Studies
  • Somatostatin / adverse effects
  • Somatostatin / analogs & derivatives*
  • Somatostatin / pharmacokinetics
  • Somatostatin / therapeutic use

Substances

  • Indium Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Peptide
  • Somatostatin
  • pentetreotide