Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539. Issue 1 (3rd June 2022)

• Record Type: Journal Article
• Authors: Rogers, C Leland; Pugh, Stephanie L; Vogelbaum, Michael A; Perry, Arie; Ashby, Lynn S; Modi, Jignesh M; Alleman, Anthony M; Barani, Igor J; Braunstein, Steve; Bovi, Joseph A; de Groot, John F; Whitton, Anthony C; Lindhorst, Scott M; Deb, Nimisha; Shrieve, Dennis C; Shu, Hui-Kuo; Bloom, Beatrice; Machtay, Mitchell; Mishra, Mark V; Robinson, Clifford G; Won, Minhee; Mehta, Minesh P
• Is Part Of: Neuro-oncology. Volume 25:Issue 1(2023)
• Page Start: 137
• Page End: 145
• Publication Date: 2022-06-03
• Subjects: cooperative group trial -- meningioma -- observation -- surgery -- WHO grade 1 (benign); Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noac137
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Background: Three- and five-year progression-free survival (PFS) for low-risk meningioma managed with surgery and observation reportedly exceeds 90%. Herewith we summarize outcomes for low-risk meningioma patients enrolled on NRG/RTOG 0539. Methods: This phase II trial allocated patients to one of three groups per World Health Organization grade, recurrence status, and resection extent. Low-risk patients had either gross total (GTR) or subtotal resection (STR) for a newly diagnosed grade 1 meningioma and were observed after surgery. The primary endpoint was 3-year PFS. Adverse events (AEs) were scored using Common Terminology Criteria for Adverse Events (CTCAE) version 3. Results: Among 60 evaluable patients, the median follow-up was 9.1 years. The 3-, 5-, and 10-year rates were 91.4% (95% CI, 84.2 to 98.6), 89.4% (95% CI, 81.3 to 97.5), 85.0% (95% CI, 75.3 to 94.7) for PFS and 98.3% (95% CI, 94.9 to 100), 98.3%, (95% CI, 94.9 to 100), 93.8% (95% CI, 87.0 to 100) for overall survival (OS), respectively. With centrally confirmed GTR, 3/5/10y PFS and OS rates were 94.3/94.3/87.6% and 97.1/97.1/90.4%. With STR, 3/5/10y PFS rates were 83.1/72.7/72.7% and 10y OS 100%. Five patients reported one grade 3, four grade 2, and five grade 1 AEs. There were no grade 4 or 5 AEs. Conclusions: These results prospectively validate high PFS and OS for low-risk meningioma managed surgically but raise questions regarding optimal management following STR, a subcohort that could potentially benefit from adjuvant therapy.