title: Recurrent high-grade meningioma: a phase II trial with somatostatin analogue therapy.
abstract: OBJECTIVE
  A prospective, two-stage phase II trial with octreotide in patients with recurrent high-grade meningioma was conducted. The radiographic partial response (RPR) was set as the primary study endpoint, whereas progression-free survival at 6 months (PFS6) was defined as the secondary endpoint.
  
  
  METHODS
  Nine patients (eight men; median age 65) with histological high-grade meningioma (five with grade II and four with grade III) and progression after prior surgery and radiotherapy were included. All had positive brain octreotide SPECT scanning. Octreotide was administered intramuscularly once every 28 days at a dose of 30 mg for the first two cycles and 40 mg for subsequent cycles until progression. Magnetic resonance imaging was performed every 3 months. Progression and RPR were defined as an increase of ≥25 % and as a decrease of ≥50 % in two-dimensional maximum diameters, respectively.
  
  
  RESULTS
  Patients received a median of three octreotide cycles (range 1-8) without grade ≥2 toxicities. No RPRs were observed. Stable disease was the best response in 33.3 % (n = 3). All patients had progressive disease at 10 months of follow-up. Median time to progression was 4.23 months (range 1-9.4), and the PFS6 was 44.4 % (n = 4).
  
  
  CONCLUSIONS
  Our study failed to provide evidence to support the use of monthly long-acting somatostatin analogue schedule in recurrent high-grade meningiomas, as none of our patients demonstrated RPR. The modest median PFS of 4-5 months along with the unknown natural history of recurrent meningiomas render the use of this therapy against these aggressive brain tumors uncertain.
authors.affiliation: Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO Duran i Reynals and Institut de Diagnòstic per la Imatge, C/Feixa Llarga s/n, 08907, L'Hospitalet del Llobregat, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Simó
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Argyriou
authors.forename: Miquel
authors.initials: M
authors.lastname: Macià
authors.forename: Gerard
authors.initials: G
authors.lastname: Plans
authors.forename: Carles
authors.initials: C
authors.lastname: Majós
authors.forename: Noemi
authors.initials: N
authors.lastname: Vidal
authors.forename: Miguel
authors.initials: M
authors.lastname: Gil
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruna
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008579:Meningioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015282:Octreotide / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D013004:Somatostatin; D015282:Octreotide