Somatostatin analogues in treatment-refractory meningioma: a systematic review with meta-analysis of individual patient data.

Everolimus / therapeutic use Humans Meningeal Neoplasms / drug therapy Meningioma / drug therapy Prospective Studies Receptors, Somatostatin / therapeutic use Somatostatin / therapeutic use

Meningioma Meta-analysis Neuro-oncology Progressive Treatment-refractory

Journal

Neurosurgical review

ISSN: 1437-2320

Titre abrégé: Neurosurg Rev

Pays: Germany

ID NLM: 7908181

Informations de publication

Date de publication:
Oct 2022

Historique:

received: 24 03 2022

accepted: 10 08 2022

revised: 01 08 2022

pubmed: 20 8 2022

medline: 24 9 2022

entrez: 19 8 2022

Statut: ppublish

Résumé

Treatment-refractory meningiomas have a dismal prognosis and limited treatment options. Meningiomas express high-densities of somatostatin receptors (SSTR), thus potentially susceptible to antitumorigenic effects of somatostatin analogues (SSA). Evidence for SSA in meningiomas is scarce, and it is unclear if published literature would either (1) support wider use of SSA, if (2) more evidence is desirable, or if (3) available evidence is sufficient to discard SSA. We addressed the need for more evidence with a systematic review and meta-analysis. We performed an individual patient data (IPD) meta-analysis. Main outcomes were toxicity, best radiological response, progression-free survival, and overall survival. We applied multivariable logistic regression models to estimate the effect of SSA on the probability of obtaining radiological disease control. The predictive performance was evaluated using area under the curve and Brier scores. We included 16 studies and compiled IPD from 8/9 of all previous cohorts. Quality of evidence was overall ranked "very low." Stable disease was reported in 58% of patients as best radiological response. Per 100 mg increase in total SSA dosage, the odds ratios for obtaining radiological disease control was 1.42 (1.11 to 1.81, P = 0.005) and 1.44 (1.00 to 2.08, P = 0.05) for patients treated with SSA as monodrug therapy vs SSA in combination with everolimus, respectively. Low quality of evidence impeded exact quantification of treatment efficacy, and the association between response and treatment may represent reverse causality. Yet, the SSA treatment was well tolerated, and beneficial effect cannot be disqualified. A prospective trial without bias from inconsistent study designs is warranted to assess SSA therapy for well-defined meningioma subgroups.

Identifiants

DOI: 10.1007/s10143-022-01849-6 PMID: 35984552

pubmed: 35984552

doi: 10.1007/s10143-022-01849-6

pii: 10.1007/s10143-022-01849-6

doi:

Substances chimiques

Receptors, Somatostatin 0

Somatostatin 51110-01-1

Everolimus 9HW64Q8G6G

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

Pagination

3067-3081

Informations de copyright

Références

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