Everolimus and Octreotide for Patients with Recurrent Meningioma: Results from the Phase II CEVOREM Trial

Graillon, Thomas; Sanson, Marc; Campello, Chantal; Idbaïh, Ahmed; Peyre, Matthieu; Peyrière, Hadrien; Basset, Noémie; Autran, Didier; Roche, Catherine; Kalamaridès, Michel; Roche, Pièrre-Hugues; Fuentès, S.; Tabouret, Émeline; Barrié, Maryline; Cohen, Anita; Honoré, Stéphane; Boucékine, Mohamed; Baumstarck, Karine; Figarella‐Branger, Dominique; Barlier, Anne; Dufour, Henry; Chinot, Olivier

doi:10.1158/1078-0432.ccr-19-2109

Cited by 93 publications

(109 citation statements)

References 33 publications

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“…After 3 months of treatment, the growth rate of 78% tumor volume decreased significantly, that is the decrease was more than 50%. The study suggests that the combination of everolimus and octreotide has better antimeningioma activity (103).…”

Section: Chemotherapymentioning

confidence: 96%

An Overview of Managements in Meningiomas

Zhao

Hou

et al. 2020

Front. Oncol.

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Meningioma is the most frequent primary tumor of the central nervous system. Important advances have been achieved in the treatment of meningioma in recent decades. Although most meningiomas are benign and have a good prognosis after surgery, clinicians often face challenges when the morphology of the tumor is complicated or the tumor is close to vital brain structures. At present, the longstanding treatment strategies of meningioma are mainly surgery and radiotherapy. The effectiveness of systemic therapy, such as chemotherapy or targeted therapy, has not been confirmed by big data series, and some clinical trials are still in progress. In this review, we summarize current treatment strategies and future research directions for meningiomas.

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Section: Chemotherapymentioning

confidence: 96%

An Overview of Managements in Meningiomas

Zhao

Hou

et al. 2020

Front. Oncol.

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“…Analysis indicated PFS6 of 44%, median TTP (23). The prospective phase II clinical trial by Graillon et al evaluated the benefits of combination of everolimus and octreotide in patients with recurrent meningioma who were ineligible for further interventions (24). The PFS at 6 months was 55%, the overall survival rates at 6 and 12 months were 90 and 75%, respectively (24).…”

Section: Discussionmentioning

confidence: 99%

“…It was suggested that even though no radiographical tumor regression was detected, Sandostatin LAR may arrest tumor progression (17). Only recent Phase II clinical trial that evaluated the effectiveness of combination of everolimus and octreotide showed that among the 20 study patients, radiological regression in the tumor volume by >10% was identified in 4 patients (24).…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Interventional Cohort Study to Assess the Safety and Efficacy of Sandostatin LAR for Treatment of Recurrent and/or Refractory Meningiomas

Hrachova

Nguyen

et al. 2020

Front. Neurol.

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Background: Meningiomas are the most common adult primary intracranial tumors in the United States. Despite high recurrence rate of atypical and malignant subtypes, there is no approved drug indicated specifically for meningioma. Since the majority of meningiomas exhibit high density of somatostatin receptors subtypes, somatostatin analogs have been under close investigation. The aim of this study was to evaluate efficacy and safety of Sandostatin LAR (octreotide) in patients with progressive, and/or recurrent meningioma, and identify subset of patients who were more likely to benefit from this treatment. Methods: A total of 43 patients ≥ 18 years old were included in the retrospective chart review. The patients underwent treatment with Sandostatin LAR (octreotide) from 01.01.2010 to 06.01.2017 at the University of California, Irvine after confirmation of the diagnosis. Six months progression free survival (PFS6) was defined as a primary endpoint, and the overall survival (OS), safety, and toxicity were identified as secondary endpoints. Results: The OS for 6 months, 1, and 3 years for all WHO grades was 94.8, 88.1, and 67.0%, respectively. The PFS6 for WHO I, II, III, and all was 89.4, 89, 33.3, and 80% respectively. For patients with no prior surgeries, chemotherapy or radiation, the PFS6 was 88.9, 84.8, and 94.8%, respectively. Interestingly, the PFS6 was 90.5% for skull-based and 80% for 3-6 cm tumors. Patients with tumors in parasagittal location had PFS6 of 83.3% compared to PFS6 of 50.0% for patients with convexity tumors. Evaluation of PFS6 based on the effect of estrogen and progesterone on meningioma identified that ER-PR+ tumors had PFS6 of 87.8% while patients with ER-PR-meningiomas had PFS6 of 62.5%. Median TTP for WHO grade I, II, and III was 3.1, 2.40, and 0.26 years, respectively. Subgroup analysis showed that median TTP was 3.1 Hrachova et al. Sandostatin LAR for Recurrent and/or Refractory Meningiomas years for < 3 cm tumors, 3.22 years for skull-based tumors, 2.37 years for patients with prior surgeries and 3.10 years for patients with no history of chemotherapy. History of radiation had no effect on median TTP. Sandostatin LAR (octreotide) was well-tolerated. Conclusions: This is one of the largest retrospective analysis of meningioma patients treated with Sandostatin LAR (octreotide) suggesting that this treatment has minimal to no adverse events and could prolong overall survival, and progression free survival especially for patients with ER-PR+ tumors who underwent surgeries for small skull-based tumors.

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“…Medical therapies are rarely necessary in this location. For aggressive multirecurrent meningiomas, the combination of everolimus and octreotide as anti-VEGF drugs are of interest [112][113][114]. Somatostatine alone could be relevant for nonresectable skull base slowly growing meningiomas [24,115].…”

Section: Medical Therapiesmentioning

confidence: 99%

Parasellar Meningiomas

Graillon¹,

Régis²,

Barlier³

et al. 2020

Neuroendocrinology

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Parasellar spaces remain particularly singular, comprising the most important neurovascular structures such as the internal carotid artery and optic, oculomotor, and trigeminal nerves. Meningiomas are one of the most frequent tumors arising from parasellar spaces. In this location, meningiomas remain mostly benign tumors with WHO grade I and a meningothelial subtype. Progestin intake should be investigated and leads mostly to conservative strategies. In the case of benign nonsymptomatic tumors, observation should be proposed. Tumor growth will lead to the proposition of surgery or radiosurgery. In the case of an uncertain diagnosis and an aggressive pattern, a precise diagnosis is required. For cavernous sinus and Meckel's cave lesions, complete removal is rarely considered, leading to the proposition of an endoscopic endonasal or transcranial biopsy. Optic nerve decompression could also be proposed via these approaches. A case-by-case discussion about the best approach is recommended. A transcranial approach remains necessary for tumor removal in most cases. Vascular injury could lead to severe complications. Cerebrospinal fluid leakage, meningitis, venous sacrifice, visual impairment, and cranial nerve palsies are more frequent complications. Pituitary dysfunctions are rare in preoperative assessment and in postoperative follow-up but should be assessed in the case of meningiomas located close to the pituitary axis. Long-term follow-up is required given the frequent incomplete tumor removal and the risk of delayed recurrence. Radiosurgery is relevant for small and well-limited meningiomas or intra-cavernous sinus postoperative residue, whereas radiation therapy and proton beam therapy are indicated for large, extended, nonoperable meningiomas. The place of the peptide receptor radionuclide therapy needs to be defined. Targeted therapy should be considered in rare, recurrent, and aggressive parasellar meningiomas.

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Everolimus and Octreotide for Patients with Recurrent Meningioma: Results from the Phase II CEVOREM Trial

Cited by 93 publications

References 33 publications

An Overview of Managements in Meningiomas

An Overview of Managements in Meningiomas

A Retrospective Interventional Cohort Study to Assess the Safety and Efficacy of Sandostatin LAR for Treatment of Recurrent and/or Refractory Meningiomas

Parasellar Meningiomas

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