Skip to main content
SpringerLink
Log in

Peptide radionuclide radiation therapy with Lutathera in multirecurrent nonanaplastic meningiomas: antitumoral activity study by growth rate analysis

  • Research
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Several retrospective studies and meta-analyses of Peptide Radionuclide Radiation Therapy in meningiomas suggest six-month progression-free survival improvement for WHO grade 1 and 2 meningiomas. In the present study, we aimed to evaluate the impact of such treatment on three-dimensional volume growth rate (3DVGR) in nonanaplastic meningiomas.

Methods

The authors performed a retrospective study including eight patients treated with Lutathera®. Millimetric 3D T1-weighted with gadolinium enhancement magnetic resonance imaging sequences were requested for volume measurement. Then, tumor growth rate was classified following a previously described 3DVGR classification (Graillon et al.).

Results

Patients harbored seven WHO grade 2 meningiomas and one aggressive WHO grade 1. All patients, except one, underwent four treatment cycles. 3DVGR significantly decreased at 3, 6, and 12 months after treatment initiation analyzing each lesion separately. Mean and median 3DVGR from all patients were respectively at 29.5% and 44.5%/6 months before treatment initiation, then at 16.5% and 25%/6 months at three months post-treatment initiation, 9.5% and 4.5%/6 months after 6 months, as well as 9.5% and 10.5%/6 months after 12 months. At 3, 6, and 12 months after treatment initiation, 4/8, 6/7, and 5/6 patients were class 2 (stabilization or severe 3DVGR slowdown), respectively. No patient was class 1 at 6 and 12 months, suggesting a lack of drug response.

Conclusion

In nonanaplastic meningiomas, Lutathera®’s antitumoral activity appeared delayed and more likely observed at six months, while no major response was observed under treatment. Moreover, its antitumoral activity persisted for 12–18 months following treatment initiation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

No datasets were generated or analysed during the current study.

References

  1. Graillon T, Ferrer L, Siffre J, Sanson M, Peyre M, Peyriere H, Mougel G, Autran D, Tabouret E, Figarella-Branger D, Barlier A, Kalamarides M, Dufour H, Colin T, Chinot O (2021) Role of 3-D volume growth rate for drug activity evaluation in meningioma clinical trials: the example of the CEVOREM study. Neuro oncol doi: noab019 [pii]. https://doi.org/10.1093/neuonc/noab019. 6131353 [pii]

  2. Graillon T, Sanson M, Campello C, Idbaih A, Peyre M, Peyriere H, Basset N, Autran D, Roche C, Kalamarides M, Roche PH, Fuentes S, Tabouret E, Barrie M, Cohen A, Honore S, Boucekine M, Baumstarck K, Figarella-Branger D, Barlier A, Dufour H, Chinot OL (2020) Everolimus and Octreotide for patients with recurrent Meningioma: results from the phase II CEVOREM trial. Clin Cancer Res 26:552–557. https://doi.org/10.1158/1078-0432.CCR-19-21091078– 0432.CCR-19-2109 [pii]

    Article  CAS  PubMed  Google Scholar 

  3. Lou E, Sumrall AL, Turner S, Peters KB, Desjardins A, Vredenburgh JJ, McLendon RE, Herndon JE 2nd, McSherry F, Norfleet J, Friedman HS, Reardon DA (2012) Bevacizumab therapy for adults with recurrent/progressive meningioma: a retrospective series. J Neurooncol 109:63–70. https://doi.org/10.1007/s11060-012-0861-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Lee EQ, Drappatz J, Omuro A, Kaley TJ (2012) Atypical and anaplastic meningiomas treated with bevacizumab. J Neurooncol 109:187–193. https://doi.org/10.1007/s11060-012-0886-4

    Article  CAS  PubMed  Google Scholar 

  5. Graillon T, Romano D, Defilles C, Saveanu A, Mohamed A, Figarella-Branger D, Roche PH, Fuentes S, Chinot O, Dufour H, Barlier A (2017) Octreotide therapy in meningiomas: in vitro study, clinical correlation, and literature review. J Neurosurg 127:660–669. https://doi.org/10.3171/2016.8.JNS16995

    Article  CAS  PubMed  Google Scholar 

  6. Barresi V, Alafaci C, Salpietro F, Tuccari G (2008) Sstr2A immunohistochemical expression in human meningiomas: is there a correlation with the histological grade, proliferation or microvessel density? Oncol Rep 20:485–492

    CAS  PubMed  Google Scholar 

  7. Fodi C, Skardelly M, Hempel JM, Hoffmann E, Castaneda S, Tabatabai G, Honegger J, Tatagiba M, Schittenhelm J, Behling F (2022) The immunohistochemical expression of SSTR2A is an independent prognostic factor in meningioma. Neurosurg Rev 45:2671–2679. https://doi.org/10.1007/s10143-021-01651-w [pii]. 1651 [pii]

    Article  PubMed  Google Scholar 

  8. Horowitz T, Salgues B, Padovani L, Farah K, Dufour H, Chinot O, Guedj E, Graillon T (2023) Optic nerve sheath meningiomas: solving Diagnostic challenges with (68)Ga-DOTATOC PET/CT. Diagnostics (Basel) 13. https://doi.org/10.3390/diagnostics13132307. 2307. diagnostics13132307 [pii]. diagnostics-13-02307 [pii]

  9. Graillon T, Regis J, Barlier A, Brue T, Dufour H, Buchfelder M (2020) Parasellar Meningiomas Neuroendocrinol. https://doi.org/10.1159/000509090. 000509090 [pii]

    Article  Google Scholar 

  10. Chamberlain MC, Glantz MJ, Fadul CE (2007) Recurrent meningioma: salvage therapy with long-acting somatostatin analogue. Neurology 69:969–973. https://doi.org/10.1212/01.wnl.0000271382.62776.b7. doi:69/10/969 [pii]

    Article  CAS  PubMed  Google Scholar 

  11. Norden AD, Ligon KL, Hammond SN, Muzikansky A, Reardon DA, Kaley TJ, Batchelor TT, Plotkin SR, Raizer JJ, Wong ET, Drappatz J, Lesser GJ, Haidar S, Beroukhim R, Lee EQ, Doherty L, Lafrankie D, Gaffey SC, Gerard M, Smith KH, McCluskey C, Phuphanich S, Wen PY (2015) Phase II study of monthly pasireotide LAR (SOM230C) for recurrent or progressive meningioma. Neurology 84:280–286. https://doi.org/10.1212/WNL.0000000000001153. WNL.0000000000001153 [pii]

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Schulz C, Mathieu R, Kunz U, Mauer UM (2011) Treatment of unresectable skull base meningiomas with somatostatin analogs. Neurosurg Focus 30:E11. https://doi.org/10.3171/2011.1.FOCUS111

    Article  PubMed  Google Scholar 

  13. Galldiks N, Hattingen E, Langen KJ, Tonn JC (2023) Imaging characteristics of meningiomas. Adv Exp Med Biol 1416:21–33. https://doi.org/10.1007/978-3-031-29750-2_3

    Article  CAS  PubMed  Google Scholar 

  14. Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A, Mittra E, Wolin EM, Yao JC, Pavel ME, Grande E, Van Cutsem E, Seregni E, Duarte H, Gericke G, Bartalotta A, Mariani MF, Demange A, Mutevelic S, Krenning EP (2021) (177)Lu-Dotatate plus long-acting octreotide versus high–dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial. Lancet Oncol 22:1752–1763:S1470-2045(21)00572-6 [pii]. https://doi.org/10.1016/S1470-2045(21)00572-6

    Article  CAS  PubMed  Google Scholar 

  15. Bartolomei M, Bodei L, De Cicco C, Grana CM, Cremonesi M, Botteri E, Baio SM, Arico D, Sansovini M, Paganelli G (2009) Peptide receptor radionuclide therapy with (90)Y-DOTATOC in recurrent meningioma. Eur J Nucl Med Mol Imaging 36:1407–1416. https://doi.org/10.1007/s00259-009-1115-z

    Article  CAS  PubMed  Google Scholar 

  16. Mirian C, Duun-Henriksen AK, Maier A, Pedersen MM, Jensen LR, Bashir A, Graillon T, Hrachova M, Bota D, van Essen M, Spanjol P, Kreis C, Law I, Broholm H, Poulsgaard L, Fugleholm K, Ziebell M, Munch T, Walter MA, Mathiesen T (2021) Somatostatin receptor-targeted Radiopeptide Therapy in Treatment-Refractory Meningioma: individual Patient Data Meta-analysis. J Nucl Med 62:507–513. https://doi.org/10.2967/jnumed.120.249607.jnumed.120.249607. [pii]

    Article  CAS  PubMed  Google Scholar 

  17. Salgues B, Graillon T, Horowitz T, Chinot O, Padovani L, Taieb D, Guedj E (2022) Somatostatin receptor theranostics for refractory meningiomas. Curr Oncol 29:5550–5565. https://doi.org/10.3390/curroncol29080438. curroncol29080438 [pii]. curroncol-29-00438 [pii]

    Article  PubMed  PubMed Central  Google Scholar 

  18. Seystahl K, Stoecklein V, Schuller U, Rushing E, Nicolas G, Schafer N, Ilhan H, Pangalu A, Weller M, Tonn JC, Sommerauer M, Albert NL (2016) Somatostatin receptor-targeted radionuclide therapy for progressive meningioma: benefit linked to 68Ga-DOTATATE/-TOC uptake. Neuro Oncol 18:1538–1547:now060 [pii]. https://doi.org/10.1093/neuonc/now060

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. van Essen M, Krenning EP, Kooij PP, Bakker WH, Feelders RA, de Herder WW, Wolbers JG, Kwekkeboom DJ (2006) Effects of therapy with [177Lu-DOTA0, Tyr3]octreotate in patients with paraganglioma, meningioma, small cell lung carcinoma, and melanoma. J Nucl Med 47: 1599–1606 doi:47/10/1599 [pii]

  20. Marincek N, Radojewski P, Dumont RA, Brunner P, Muller-Brand J, Maecke HR, Briel M, Walter MA (2015) Somatostatin receptor-targeted radiopeptide therapy with 90Y-DOTATOC and 177Lu-DOTATOC in progressive meningioma: long-term results of a phase II clinical trial. J Nucl Med 56:171–176. https://doi.org/10.2967/jnumed.114.147256.jnumed.114.147256. [pii]

    Article  PubMed  Google Scholar 

  21. Gerster-Gillieron K, Forrer F, Maecke H, Mueller-Brand J, Merlo A, Cordier D (2015) 90Y-DOTATOC as a therapeutic option for Complex Recurrent or Progressive meningiomas. J Nucl Med 56:1748–1751. https://doi.org/10.2967/jnumed.115.155853. jnumed.115.155853 [pii]

    Article  CAS  PubMed  Google Scholar 

  22. Parghane RV, Talole S, Basu S (2019) Prevalence of hitherto unknown brain meningioma detected on (68)Ga-DOTATATE positron-emission tomography/computed tomography in patients with metastatic neuroendocrine tumor and exploring potential of (177)Lu-DOTATATE peptide receptor radionuclide therapy as single-shot treatment approach targeting both tumors. World J Nucl Med 18:160–170. https://doi.org/10.4103/wjnm.WJNM_39_18. WJNM-18-160 [pii]

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kreissl MC, Hanscheid H, Lohr M, Verburg FA, Schiller M, Lassmann M, Reiners C, Samnick SS, Buck AK, Flentje M, Sweeney RA (2012) Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma. Radiat Oncol 7:99. https://doi.org/10.1186/1748-717X-7-99. [pii]

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kaley T, Barani I, Chamberlain M, McDermott M, Panageas K, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P (2014) Historical benchmarks for medical therapy trials in surgery- and radiation-refractory meningioma: a RANO review. Neuro Oncol 16:829–840. https://doi.org/10.1093/neuonc/not330. not330 [pii]

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nestle U, Kremp S, Schaefer-Schuler A, Sebastian-Welsch C, Hellwig D, Rube C, Kirsch CM (2005) Comparison of different methods for delineation of 18F-FDG PET-positive tissue for target volume definition in radiotherapy of patients with non-small cell lung cancer. J Nucl Med 46:1342–1348:46/8/1342 [pii]

    PubMed  Google Scholar 

  26. Nioche C, Orlhac F, Boughdad S, Reuze S, Goya-Outi J, Robert C, Pellot-Barakat C, Soussan M, Frouin F, Buvat I (2018) LIFEx: a freeware for Radiomic feature calculation in Multimodality Imaging to accelerate advances in the characterization of Tumor Heterogeneity. Cancer Res 78:4786–4789. https://doi.org/10.1158/0008-5472.CAN-18-0125. [pii]

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Aix Marseille Univ, INSERM, APHM, MMG, UMR1251, Marmara Institute, La Timone Hospital, 264 rue Saint-Pierre, 13005, Marseille, France

    Thomas Graillon

  2. CERIMED, Nuclear Medicine Department, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Aix-Marseille University, Marseille, France

    Betty Salgues, Tatiana Horowitz & Eric Guedj

  3. Radiotherapy Department, APHM, Timone Hospital, Marseille, France

    Laetitia Padovani

  4. Service d’Anatomie Pathologique et de Neuropathologie, APHM, CHU Timone, Marseille, France

    Romain Appay

  5. Inst Neurophysiopathol, GlioME Team, Aix-Marseille Univ, CNRS, INP, PETRA network, Marseille, France

    Romain Appay

  6. Neuro-Oncology Department, APHM, Timone Hospital, Marseille, France

    Emeline Tabouret & Olivier Chinot

  7. Aix Marseille Univ, CNRS, Ecole Centrale Marseille, UMR 7249, Institut Fresnel, Marseille, France

    Emeline Tabouret

Authors
  1. Thomas Graillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Betty Salgues
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tatiana Horowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laetitia Padovani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Romain Appay
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emeline Tabouret
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eric Guedj
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Olivier Chinot
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: [TG, OC]; Methodology: [TG, BS, ET, OC]; Formal analysis and investigation: [TG, BS, TH, RA, EG]; Writing - original draft preparation: [TG, ET, OC]; Writing - review and editing: [TG, BS, TH, LP, RA, ET, EG, OC]; Supervision: [OC, EG]

Corresponding author

Correspondence to Thomas Graillon.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the French National College of Neurosurgery n° IRB00011687.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary Material 2

Supplementary Material 3

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Graillon, T., Salgues, B., Horowitz, T. et al. Peptide radionuclide radiation therapy with Lutathera in multirecurrent nonanaplastic meningiomas: antitumoral activity study by growth rate analysis. J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04622-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11060-024-04622-5

Keywords

Search

Navigation