Benchmarking the efficacy of salvage systemic therapies for recurrent meningioma: A RANO group systematic review and meta-analysis to guide clinical trial design Journal Article
| Authors: | Kotecha, R.; Akdemir, E. Y.; Kutuk, T.; Ilgin, C.; Ahluwalia, M. S.; Bi, W. L.; Blakeley, J.; Dixit, K. S.; Dunn, I. F.; Galanis, E.; Galldiks, N.; Huang, R. Y.; Johnson, D. R.; Kaley, T. J.; Kamson, D. O.; Kurz, S. C.; McDermott, M. W.; Odia, Y.; Preusser, M.; Raizer, J.; Reardon, D. A.; Rogers, C. L.; Ruda, R.; Schiff, D.; Vogelbaum, M. A.; Weller, M.; Wen, P. Y.; Mehta, M. P. |
| Article Title: | Benchmarking the efficacy of salvage systemic therapies for recurrent meningioma: A RANO group systematic review and meta-analysis to guide clinical trial design |
| Abstract: | Background Despite advances in our understanding of the molecular underpinnings of meningioma progression and innovations in systemic and local treatments, recurrent meningiomas remain a substantial therapeutic challenge. The objective of this systematic review and meta-analysis is to provide a historical baseline, contemporary analysis, and propose a "rate of probable interest" to inform future clinical trial design and development on behalf of the Response Assessment in Neuro-Oncology meningioma group.Methods PubMed, ClinicalTrials.gov, and ASCOpubs databases were screened for clinical trials evaluating the activity of systemic therapies for adults with recurrent meningiomas. The pooled progression-free survival at 6-months and 1-year (PFS-6 and PFS-1 year) values were calculated using the random effects technique with I2 indices.Results The pooled PFS-6 and PFS-1 year rates for recurrent WHO grade 1 meningiomas were 43.6% (95% CI: 22.7-67.0%, I2 = 80%) and 21.7% (95% CI: 6.2-53.9%, I2 = 76%), and for grades 2-3 meningiomas, the PFS-6 was 38.0% (95% CI: 28.3-48.8%, I2 = 68%). In the targeted therapy group, PFS-6 and PFS-1 year rates stood at 62.0% (I2 = 58%) and 49.0% (I2 = 63%) for grade 1, while for grades 2-3 tumors, the PFS-6 rates with targeted therapy and immunotherapy were 42.1% (I-2 = 60%) and 46.0% (I-2 = 0%), respectively. The benchmarks were set at 67% and 54% for PFS-6 and PFS-1 year for grade 1 tumors, and PFS-6 of 49% for grades 2-3 tumors.Conclusions Several studies have reported outcomes in patients with recurrent meningiomas testing a variety of agents with modest, but variable and progressively increasing activity. In this context, we recommend new benchmarks for future trials to define efficacy of future investigational therapies. |
| Keywords: | systemic therapy; classification; radiation; tumors; surgery; octreotide; meningioma; clinical trials; adults; phase-ii trial; refractory; recurrent; criteria; progressive meningioma; refractory meningioma |
| Journal Title: | Neuro-Oncology |
| ISSN: | 1522-8517 |
| Publisher: | Oxford University Press |
| Publication status: | Online ahead of print |
| Date Published: | 2025-01-01 |
| Online Publication Date: | 2025-01-01 |
| Language: | English |
| ACCESSION: | WOS:001443362500001 |
| DOI: | 10.1093/neuonc/noaf009 |
| PROVIDER: | wos |
| Notes: | Review; Early Access -- Source: Wos |
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