Peptide Receptor Radionuclide Therapy in Patients with Inoperable Meningiomas: Our Experience and Review of the Literature

Abstract

Objective:

Few studies describe peptide receptor radionuclide therapy (PRRT) using ⁹⁰Y- or ¹⁷⁷Lu-labeled peptides in patients with recurrent meningiomas. No clinical data about ¹¹¹In-Pentetreotide in such patients are available. We report on ¹¹¹In-Pentetreotide therapy in patients with inoperable meningiomas and review the literature about PRRT of meningiomas.

Methods:

We reviewed clinical records of 8 patients with meningioma/meningiomatosis showing high ¹¹¹In-Pentetreotide uptake on pretherapy scintigraphy who were treated with at least one cycle of ¹¹¹In-Pentetreotide. In 2 patients, a cocktail of ¹¹¹In-Pentetreotide and beta-emitting radiolabeled peptides had been administered.

Results:

No patient experienced acute toxicity, neurological or renal function impairment. Mild transient bone marrow toxicity was observed in 4 patients. Objective partial response was observed in 2 patients, stable disease in 5 and disease progression in one. There were no statistically significant correlations between objective response and patient age, tumor WHO grade, baseline Karnofsky performance score, ¹¹¹In-Pentetreotide tumoral uptake grade, tumor/nontumor ratio, disease state at baseline, and cumulative dose.

Conclusions:

In consideration of its efficacy and the lack of significant toxicity, PRRT of meningiomas using ¹¹¹In-Pentetreotide could be proposed even nowadays when the use of ¹⁷⁷Lu- or ⁹⁰Y-labeled peptides seems unsafe, namely in patients with renal impairment/toxicity.