title: IFN-α for recurrent surgery- and radiation-refractory high-grade meningioma: a retrospective case series.
abstract: OBJECTIVE
  Limited literature is available regarding the treatment of recurrent surgery- and radiation-refractory meningioma, and it primarily examines the treatment of low-grade (WHO grade 1) meningioma. Data regarding systemic therapy for recurrent high-grade meningioma are sparse. A retrospective case series of patients with recurrent WHO grade 2/3 meningioma treated with IFN-α following progression after surgery, radiotherapy and hydroxyurea was carried out, with the primary study objective of overall response rate, and median and 6-month progression-free survival (PFS).
  
  
  METHODS
  35 patients (28 women and 17 men; median age 63 years; range: 36-86 years) with recurrent high-grade meningioma (WHO grade 2 [n = 22] or 3 [n = 13]) were treated with IFN-α (10 million units/m(2)) subcutaneously every 2 days; one cycle was operationally defined as 4 weeks of IFN-α. Patients had progressed radiographically after prior therapy with surgery (35 out of 35), radiotherapy (35 out of 35; external-beam radiotherapy: 35 out of 35; and stereotactic radiotherapy: 34 out of 35) and hydroxyurea chemotherapy (35 out of 35). One patient was also treated with a somatostatin analog before initiating IFN-α treatment.
  
  
  RESULTS
  Patients received one to 13 cycles (median: three) of IFN-α with moderate toxicity (100% of patients manifested grades 1-3 toxicity, of which only 20% were grade 3). There were no radiographic responses, 63% of patients had stable disease and 37% manifested progressive disease at first evaluation. PFS was 17% at 6 months (95% CI: 0.07-0.31; median PFS: 12 weeks; 95% CI: 8-20 weeks; range: 4-52 weeks). Following progression on IFN-α, the majority of patients (60%) were subsequently treated on an alternative therapy.
  
  
  CONCLUSIONS
  In this large retrospective series, IFN-α was moderately toxic, but appeared to have limited activity in patients with recurrent high-grade meningiomas.
authors: University of Washington, Department of Neurology & Neurological Surgery, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, 825 Eastlake Avenue E, PO Box 19023, MS-G4940, Seattle, WA 98109-1023, USA. chambemc@uw.edu.
authors: Marc C
authors: MC
authors: Chamberlain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D008297:Male; D008579:Meningioma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016898:Interferon-alpha