MNGI-06. EFFICACY OF 177LU-DOTATATE THERAPY IN RECURRENT ANAPLASTIC MENINGIOMA. (11th November 2019)

• Record Type: Journal Article
• Authors: Kizilbash, Sani; Johnson, Derek
• Is Part Of: Neuro-oncology. Volume 21(2019)Supplement 6
• Page Start: vi140
• Page End: vi140
• Publication Date: 2019-11-11
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noz175.588
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: 177 Lu-Dotatate ( 177 Lu-DOTA 0 -Tyr 3 -Octreotate) is a beta-particle emitting somatostatin analog recently FDA approved for the treatment of somastatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Somatostatin receptors are highly expressed in almost all meningiomas, therefore 177 Lu-Dotatate may be a reasonable treatment strategy for this disease. Furthermore, the short path length of the beta particle should allow for treatment of previously radiated patients with low risk of cerebral radiation necrosis. CASE STUDY: A 61 year-old male presented with a history of atypical meningioma (WHO grade II), recurrent as anaplastic meningioma (WHO grade III). His previous treatments included multiple surgical resections, fractionated radiation therapy, stereotactic radiosurgery, everolimus/octreotide LAR, bevacizumab and hydroxyurea. MRI imaging revealed rapid volumetric progression over the prior nine months with a near tripling in size from 29.9 cm 3 to 80.4 cm 3 . In-111 octreotide confirmed the presence of somatostatin receptors within the tumor. 177 Lu-Dotatate was administered intravenously at a dose of 200 millicuries per dose, every eight weeks for four cycles. Treatment was tolerated very well, with no significant adverse events. Tumor volume initially increased to 98.3 cm 3 after cycle 1 of treatment, and subsequently decreased to 91.2 cm 3 after cycle 2. Eight months after treatment onset, the tumor volume remained stable (93.4 cm 3 ). CONCLUSION: 177 Lu-Dotatate may be a safe and effective strategy for the treatment of somastatin receptor-positive meningioma. The transient increase in tumor volume after the first dose in this case may have represented delayed treatment effect or pseudoprogression. A phase II clinical trial is currently being activated to determine the progression-free survival associated with 177 Lu-Dotatate in patients with recurrent meningioma.