Katharina Seystahl1, Veit Stoecklein1, Ulrich Schüller1, Elisabeth Rushing1, Guillaume Nicolas1, Niklaus Schäfer1, Harun Ilhan1, Athina Pangalu1, Michael Weller1, Jörg-Christian Tonn1, Michael Sommerauer1, Nathalie L Albert1. 1. Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland (K.S., M.W., M.S.); Department of Neurosurgery, University Hospital LMU Munich, Munich, Germany (V.S., J.-C.T.); Department of Neuropathology, University Hospital LMU Munich, Munich, Germany (U.S.); Department of Neuropathology, University Hospital Zurich, Zurich, Switzerland (E.R.); Department of Nuclear Medicine, University Hospital Basel, Basel, Switzerland (G.N.); Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland (N.S., M.S.); Department of Nuclear Medicine, University Hospital LMU Munich, Munich, Germany (H.I., N.L.A.); Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland (A.P.).
Abstract
BACKGROUND: The prognosis of patients with progressive meningioma after failure of surgery and radiotherapy is poor. METHODS: We retrospectively evaluated the safety and efficacy of somatostatin-receptor (SSTR)-targeted radionuclide therapy (177Lu-DOTATATE [n = 16], 90Y-DOTATOC [n = 3], or both [n = 1]) in patients with progressive, treatment-refractory meningiomas (5 World Health Organization [WHO] grade I, 7 WHO grade II, 8 WHO grade III) and in part multifocal disease (17 of 20 patients). RESULTS: SSTR radionuclide treatment (median of 3 treatment cycles, median administered dose/cycle 7400 MBq) led to a disease stabilization in 10 of 20 patients for a median time of 17 months. Stratification according to WHO grade showed a median progression-free survival (PFS) of 32.2 months for grade I tumors, 7.2 for grade II, and 2.1 for grade III. PFS at 6 months was 100% for grade I, 57% for grade II, and 0% for grade III. Median overall survival was 17.2 months in WHO grade III patients and not reached for WHO I and II at a median follow-up of 20 months. In the analysis of single meningioma lesions, maximal and mean standardized uptake values in pretherapeutic 68Ga-DOTATOC/-TATE PET/CT were significantly higher in those lesions with radiographic stability after 6 months. In line with this, high expression of SSTR via immunohistochemistry was associated with PFS >6 months. CONCLUSIONS: SSTR-targeted radionuclide treatment has activity in a subset of patients with meningioma. Expression of SSTR via immunohistochemistry or radionuclide uptake might serve as a predictive biomarker for outcome to facilitate individualized treatment optimization in patients with uni- and multifocal meningiomas.
BACKGROUND: The prognosis of patients with progressive meningioma after failure of surgery and radiotherapy is poor. METHODS: We retrospectively evaluated the safety and efficacy of somatostatin-receptor (SSTR)-targeted radionuclide therapy (177Lu-DOTATATE [n = 16], 90Y-DOTATOC [n = 3], or both [n = 1]) in patients with progressive, treatment-refractory meningiomas (5 World Health Organization [WHO] grade I, 7 WHO grade II, 8 WHO grade III) and in part multifocal disease (17 of 20 patients). RESULTS: SSTR radionuclide treatment (median of 3 treatment cycles, median administered dose/cycle 7400 MBq) led to a disease stabilization in 10 of 20 patients for a median time of 17 months. Stratification according to WHO grade showed a median progression-free survival (PFS) of 32.2 months for grade I tumors, 7.2 for grade II, and 2.1 for grade III. PFS at 6 months was 100% for grade I, 57% for grade II, and 0% for grade III. Median overall survival was 17.2 months in WHO grade III patients and not reached for WHO I and II at a median follow-up of 20 months. In the analysis of single meningioma lesions, maximal and mean standardized uptake values in pretherapeutic 68Ga-DOTATOC/-TATE PET/CT were significantly higher in those lesions with radiographic stability after 6 months. In line with this, high expression of SSTR via immunohistochemistry was associated with PFS >6 months. CONCLUSIONS: SSTR-targeted radionuclide treatment has activity in a subset of patients with meningioma. Expression of SSTR via immunohistochemistry or radionuclide uptake might serve as a predictive biomarker for outcome to facilitate individualized treatment optimization in patients with uni- and multifocal meningiomas.
Authors: Walter Rachinger; Veit M Stoecklein; Nicole A Terpolilli; Alexander R Haug; Lorenz Ertl; Julia Pöschl; Ulrich Schüller; Christian Schichor; Niklas Thon; Jörg-Christian Tonn Journal: J Nucl Med Date: 2015-01-29 Impact factor: 10.057
Authors: Thomas Kaley; Igor Barani; Marc Chamberlain; Michael McDermott; Katherine Panageas; Jeffrey Raizer; Leland Rogers; David Schiff; Michael Vogelbaum; Damien Weber; Patrick Wen Journal: Neuro Oncol Date: 2014-02-04 Impact factor: 12.300
Authors: Linda Villard; Anna Romer; Nicolas Marincek; Philippe Brunner; Michael T Koller; Christian Schindler; Quinn K T Ng; Helmut R Mäcke; Jan Müller-Brand; Christoph Rochlitz; Matthias Briel; Martin A Walter Journal: J Clin Oncol Date: 2012-03-05 Impact factor: 44.544
Authors: Andrew D Norden; Keith L Ligon; Samantha N Hammond; Alona Muzikansky; David A Reardon; Thomas J Kaley; Tracy T Batchelor; Scott R Plotkin; Jeffrey J Raizer; Eric T Wong; Jan Drappatz; Glenn J Lesser; Sam Haidar; Rameen Beroukhim; Eudocia Q Lee; Lisa Doherty; Debra Lafrankie; Sarah C Gaffey; Mary Gerard; Katrina H Smith; Christine McCluskey; Surasak Phuphanich; Patrick Y Wen Journal: Neurology Date: 2014-12-19 Impact factor: 9.910
Authors: Michael Sommerauer; Jan-Karl Burkhardt; Karl Frontzek; Elisabeth Rushing; Alfred Buck; Niklaus Krayenbuehl; Michael Weller; Niklaus Schaefer; Felix P Kuhn Journal: Neuro Oncol Date: 2016-02-09 Impact factor: 12.300
Authors: J W Koper; R Markstein; C Kohler; D J Kwekkeboom; C J Avezaat; S W Lamberts; J C Reubi Journal: J Clin Endocrinol Metab Date: 1992-03 Impact factor: 5.958
Authors: Marcus Unterrainer; Maximilian Niyazi; Viktoria Ruf; Peter Bartenstein; Nathalie L Albert Journal: Neuro Oncol Date: 2017-11-29 Impact factor: 12.300
Authors: Norbert Galldiks; Karl-Josef Langen; Nathalie L Albert; Marc Chamberlain; Riccardo Soffietti; Michelle M Kim; Ian Law; Emilie Le Rhun; Susan Chang; Julian Schwarting; Stephanie E Combs; Matthias Preusser; Peter Forsyth; Whitney Pope; Michael Weller; Jörg C Tonn Journal: Neuro Oncol Date: 2019-05-06 Impact factor: 12.300
Authors: Norbert Galldiks; Nathalie L Albert; Michael Sommerauer; Anca L Grosu; Ute Ganswindt; Ian Law; Matthias Preusser; Emilie Le Rhun; Michael A Vogelbaum; Gelareh Zadeh; Frédéric Dhermain; Michael Weller; Karl-Josef Langen; Jörg C Tonn Journal: Neuro Oncol Date: 2017-11-29 Impact factor: 12.300
Authors: Raymond Y Huang; Wenya Linda Bi; Brent Griffith; Timothy J Kaufmann; Christian la Fougère; Nils Ole Schmidt; Jöerg C Tonn; Michael A Vogelbaum; Patrick Y Wen; Kenneth Aldape; Farshad Nassiri; Gelareh Zadeh; Ian F Dunn Journal: Neuro Oncol Date: 2019-01-14 Impact factor: 12.300
Authors: Priscilla K Brastianos; Evanthia Galanis; Nicholas Butowski; Jason W Chan; Ian F Dunn; Roland Goldbrunner; Christel Herold-Mende; Franziska M Ippen; Christian Mawrin; Michael W McDermott; Andrew Sloan; James Snyder; Ghazaleh Tabatabai; Marcos Tatagiba; Joerg C Tonn; Patrick Y Wen; Kenneth Aldape; Farshad Nassiri; Gelareh Zadeh; Michael D Jenkinson; David R Raleigh Journal: Neuro Oncol Date: 2019-01-14 Impact factor: 12.300
Authors: Asma Bashir; Mark Bitsch Vestergaard; Tina Binderup; Helle Broholm; Lisbeth Marner; Morten Ziebell; Kåre Fugleholm; Tiit Mathiesen; Andreas Kjær; Ian Law Journal: Eur J Nucl Med Mol Imaging Date: 2020-03-13 Impact factor: 9.236
Authors: Raymond Y Huang; Prashin Unadkat; Wenya Linda Bi; Elizabeth George; Matthias Preusser; Jay D McCracken; Joseph R Keen; William L Read; Jeffrey J Olson; Katharina Seystahl; Emilie Le Rhun; Ulrich Roelcke; Susanne Koeppen; Julia Furtner; Michael Weller; Jeffrey J Raizer; David Schiff; Patrick Y Wen Journal: Neuro Oncol Date: 2019-02-14 Impact factor: 12.300
Authors: Norbert Galldiks; Maximilian Niyazi; Anca L Grosu; Martin Kocher; Karl-Josef Langen; Ian Law; Giuseppe Minniti; Michelle M Kim; Christina Tsien; Frederic Dhermain; Riccardo Soffietti; Minesh P Mehta; Michael Weller; Jörg-Christian Tonn Journal: Neuro Oncol Date: 2021-06-01 Impact factor: 12.300