Transaxial slices of baseline positron emission tomography (PET) and fused PET/magnetic resonance imaging (MRI; left) demonstrate a somatostatin receptor-expressing meningioma in the left cavernous sinus (white and black arrows). After four cycles of peptide receptor radionuclide therapy (PRRT), a complete remission according to the Response Assessment in Neuro-Oncology as well as PET criteria was recorded (right). Scale bars denote standardized uptake values. Credit: A Amerein, M Kircher, C Lapa, et al., University of Augsburg, Augsburg, Germany.
Radionuclide therapy delivered directly to an artery is safe and feasible for patients with advanced meningioma, according to new research. published in the December issue of The Journal of Nuclear MedicineIn the first long-term study of intraarterial peptide receptor radionuclide therapy (PRRT) in advanced meningioma, patients saw improved radiologic and clinical disease control compared with intravenous PRRT, with no additional toxicity.
Meningiomas are the most common primary neoplasms of the central nervous system and account for more than one-third of all cases. Meningiomas are mostly classified as benign, but 10–15% of cases are considered atypical or malignant. The preferred treatment is surgery with external beam radiotherapy. However, 30–40% of lesions are ineligible for surgery due to their location. Furthermore, recurrence rates are notably high.
“For meningioma patients who are ineligible for surgery or who experience tumor recurrence, treatment options are limited,” stated Adriana Amerein, MD, nuclear medicine resident at University Hospital Augsburg in Augsburg, Germany. “Due to the high expression of somatostatin receptors in most meningiomas, radiopharmaceutical therapy offers a viable therapeutic alternative for patients. Intraarterial administration of the radiopharmaceutical might boost the achievable radiation dose to the tumor.”
In the study, researchers assessed the long-term safety and efficacy of intraarterial PRRT in patients with advanced, progressive meningioma. Thirteen patients underwent one to four cycles of intraarterial PRRT with 177Lu-Ha-DOTATATE. Safety and treatment response was evaluated according to medical criteria, and results were compared with intravenous PRRT.
Treatment with intraarterial PRRT was well tolerated, with only transient adverse effects. The median progression-free survival for intraarterial PRRT was 18 months, and the median overall survival was not reached after 43 months. Approximately 80% of the patients showed radiologic disease control after intraarterial PRRT, compared to 40% after intravenous PRRT.
“These findings show that intraarterial administration of radiopharmaceutical therapy in meningioma is feasible, safe, and could be a promising therapeutic option in the future,” said Constantin Lapa, MD, nuclear medicine physician at University Hospital Augsburg. “Looking forward, personalized dosing and combination therapies utilizing intraarterial PRRT could further improve outcomes for patients who don’t respond to conventional therapies.”
More information:
Adriana Amerein et al, Intraarterial Administration of Peptide Receptor Radionuclide Therapy in Patients with Advanced Meningioma: Initial Safety and Efficacy, Journal of Nuclear Medicine (2024). DOI: 10.2967/jnumed.124.268217
Provided by Society of Nuclear Medicine and Molecular Imaging
Citation: Intraarterial radionuclide therapy found safe and effective for advanced meningioma patients (2024, December 11) retrieved 11 December 2024 from
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