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Purpose <p>This study evaluates safety and efficacy of peptide receptor radionuclide therapy (PRRT) as a stand-alone treatment for recurrent meningiomas and investigates the prognostic value of laboratory markers and quantitative PET parameters.</p> Methods <p>The single-center study includes 32 patients with recurrent meningioma, who underwent PRRT with [<sup>177</sup>Lu]Lu-DOTATOC/-TATE. Pre-treatment assessments comprised [<sup>68</sup>&#xa0;Ga]Ga-DOTATOC PET imaging, routine hematology and serum chemistry analysis. Outcomes including progression-free survival (PFS), overall survival (OS), and treatment related toxicity, were retrospectively evaluated using Kaplan–Meier survival analysis and Cox regression models.</p> Results <p>PRRT showed only mild hematological and renal toxicity, with most adverse events being low-grade (87%). OS was significantly shorter in patients with WHO grade III meningiomas (10&#xa0;months) compared to grade I (not reached, HR 4.77, <i>p</i> &lt; 0.01) and grade II (47&#xa0;months, HR 4.05, <i>p</i> = 0.01). Similarly, PFS was shorter in patients with WHO grade III meningiomas (4.5&#xa0;months) compared to grade I (17&#xa0;months, HR 6.47, <i>p</i> &lt; 0.001) and grade II (17&#xa0;months, HR 2.71, <i>p</i> = 0.02). In multivariable analysis, only higher WHO grade was an independent predictor of disease progression, while baseline PET and laboratory parameters showed no consistent association. Furthermore, increase of SSTR-positive tumor volume in follow-up PET was associated with shorter PFS (HR 1.02, <i>p</i> = 0.02).</p> Conclusion <p>PRRT is a safe treatment option and appears to have a favourable effect in patients with recurrent meningiomas. WHO tumor grade is the strongest predictor of PFS and OS, while baseline PET parameters appear to have no prognostic value.</p>

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SSTR-directed peptide receptor radionuclide therapy for recurrent meningiomas: analysis of safety, efficacy and prognostic factors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月2日

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  • Natalie Hasenauer,
  • Miriam Müller,
  • Heribert Hänscheid,
  • Sebastian E. Serfling,
  • Kerstin Michalski,
  • Marieke Heinrich,
  • Bülent Polat,
  • Andreas K. Buck,
  • Rudolf A. Werner,
  • Philipp E. Hartrampf

摘要

Purpose

This study evaluates safety and efficacy of peptide receptor radionuclide therapy (PRRT) as a stand-alone treatment for recurrent meningiomas and investigates the prognostic value of laboratory markers and quantitative PET parameters.

Methods

The single-center study includes 32 patients with recurrent meningioma, who underwent PRRT with [177Lu]Lu-DOTATOC/-TATE. Pre-treatment assessments comprised [68 Ga]Ga-DOTATOC PET imaging, routine hematology and serum chemistry analysis. Outcomes including progression-free survival (PFS), overall survival (OS), and treatment related toxicity, were retrospectively evaluated using Kaplan–Meier survival analysis and Cox regression models.

Results

PRRT showed only mild hematological and renal toxicity, with most adverse events being low-grade (87%). OS was significantly shorter in patients with WHO grade III meningiomas (10 months) compared to grade I (not reached, HR 4.77, p < 0.01) and grade II (47 months, HR 4.05, p = 0.01). Similarly, PFS was shorter in patients with WHO grade III meningiomas (4.5 months) compared to grade I (17 months, HR 6.47, p < 0.001) and grade II (17 months, HR 2.71, p = 0.02). In multivariable analysis, only higher WHO grade was an independent predictor of disease progression, while baseline PET and laboratory parameters showed no consistent association. Furthermore, increase of SSTR-positive tumor volume in follow-up PET was associated with shorter PFS (HR 1.02, p = 0.02).

Conclusion

PRRT is a safe treatment option and appears to have a favourable effect in patients with recurrent meningiomas. WHO tumor grade is the strongest predictor of PFS and OS, while baseline PET parameters appear to have no prognostic value.