Julia Furtner1, Veronika Schöpf1, Katharina Seystahl1, Emilie Le Rhun1, Roberta Rudà1, Ulrich Roelcke1, Susanne Koeppen1, Anna Sophie Berghoff1, Christine Marosi1, Paul Clement1, Marina Faedi1, Colin Watts1, Wolfgang Wick1, Riccardo Soffietti1, Michael Weller1, Matthias Preusser1. 1. Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (J.F., V.S.); Department of Psychology, University of Graz, Graz, Austria (V.S.); BioTechMed, Graz, Austria (V.S.); Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland (K.S., M.W.); Department of Neuro-oncology, University Hospital, Lille, France (E.L.R.); Breast Cancer Department, Oscar Lambret Center, Lille, France (E.L.R.); PRISM Inserm U1191, Villeneuve D'Ascq, France (E.L.R.); Department of Neuro-Oncology, University of Torino, Torino, Italy (R.R., R.S.); Department of Neurology and Brain Tumor Center, Cantonal Hospital Aarau, Aarau, Switzerland (U.R.); Department of Neurology, University of Essen, Essen, Germany (S.K.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., C.M., M.P.); Department of Oncology, KU Leuven, Leuven, Belgium (P.C.); Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy (M.F.); Department of Clinical Neurosciences, Division of Neurosurgery, University of Cambridge, Cambridge, England (C.W.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.).
Abstract
BACKGROUND: The efficacy of systemic antineoplastic therapy on recurrent World Health Organization (WHO) grades II and III meningiomas is unclear. METHODS: We performed a retrospective multicenter analysis of serial cranial MRI in patients with recurrent WHO II and III meningiomas treated with antineoplastic systemic therapies. Growth rates for tumor volume and diameter, as well as change rates for edema size, were calculated for all lesions. RESULTS: We identified a total of 34 patients (23 atypical, 11 anaplastic meningiomas) with a total of 57 meningioma lesions who had been treated at 6 European institutions. Systemic therapies included bevacizumab, cytotoxic chemotherapy, somatostatin analogues, and tyrosine kinase inhibitors. Overall, tumor growth rates decreased during systemic therapy by 51% for tumor diameter and 14% for tumor volume growth rates compared with the period before initiation of systemic therapy. The most pronounced decrease in meningioma growth rates during systemic therapy was evident in patients treated with bevacizumab, with a reduction of 80% in diameter and 59% in volume growth. Furthermore, a decrease in size of peritumoral edema after initiation of systemic therapy was exclusively observed in patients treated with bevacizumab (-107%). CONCLUSIONS: Our data indicate that systemic therapy may inhibit growth of recurrent WHO grades II and III meningiomas to some extent. In our small cohort, bevacizumab had the most pronounced inhibitory effect on tumor growth, as well as some anti-edematous activity. Prospective studies are needed to better define the role of medical therapies in this tumor type.
BACKGROUND: The efficacy of systemic antineoplastic therapy on recurrent World Health Organization (WHO) grades II and III meningiomas is unclear. METHODS: We performed a retrospective multicenter analysis of serial cranial MRI in patients with recurrent WHO II and III meningiomas treated with antineoplastic systemic therapies. Growth rates for tumor volume and diameter, as well as change rates for edema size, were calculated for all lesions. RESULTS: We identified a total of 34 patients (23 atypical, 11 anaplastic meningiomas) with a total of 57 meningioma lesions who had been treated at 6 European institutions. Systemic therapies included bevacizumab, cytotoxic chemotherapy, somatostatin analogues, and tyrosine kinase inhibitors. Overall, tumor growth rates decreased during systemic therapy by 51% for tumor diameter and 14% for tumor volume growth rates compared with the period before initiation of systemic therapy. The most pronounced decrease in meningioma growth rates during systemic therapy was evident in patients treated with bevacizumab, with a reduction of 80% in diameter and 59% in volume growth. Furthermore, a decrease in size of peritumoral edema after initiation of systemic therapy was exclusively observed in patients treated with bevacizumab (-107%). CONCLUSIONS: Our data indicate that systemic therapy may inhibit growth of recurrent WHO grades II and III meningiomas to some extent. In our small cohort, bevacizumab had the most pronounced inhibitory effect on tumor growth, as well as some anti-edematous activity. Prospective studies are needed to better define the role of medical therapies in this tumor type.
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