PRRT using somatostatin-targeting peptides achieved 57% disease control in 42 patients with meningiomas that had failed surgery and radiotherapy, with median overall survival of 36 months and excellent tolerability.
57% disease controlSomatostatin peptide-targeted PRRT controlled disease in 57% of meningioma patients who had run out of standard treatment options
What the researchers found
42 patients treated with PRRT (5 with 90Y-DOTATOC, 37 with 177Lu-DOTATATE). Disease control rate: 57%. Median PFS: 16 months. Median OS: 36 months (63-month follow-up). 6 patients retreated with 177Lu-PRRT (retreatment PFS: 6.5 months, OS: 17 months). Only 1 treatment discontinuation for grade 3 platelet toxicity.
Why it matters
Recurrent meningiomas after surgery and radiation have essentially no effective third-line treatment options. PRRT targeting somatostatin receptors provides a viable therapeutic option for these patients, with meaningful disease control and a favorable side effect profile.
The numbers in context
Long-term follow-up data. Diagnosis with 68Ga-DOTA-octreotide PET/CT; treatment with 90Y/177Lu-DOTA-octreotide.
How the study worked
Single-center retrospective cohort study. 42 meningioma patients with radiologic recurrence after surgery and radiotherapy treated with 90Y-DOTATOC (1.1-5.5 GBq) or 177Lu-DOTATATE (3.7-5.5 GBq) in ~4 cycles (Oct 2009-Oct 2021). All confirmed somatostatin receptor overexpression on 68Ga-DOTATOC PET/CT or 111In-octreotide scan.
Who was studied
Patients with refractory meningiomas after surgery and radiotherapy
What this study cannot tell us
Retrospective single-center study. No control group. Mixed use of two different radioisotopes (90Y and 177Lu). Small retreatment cohort (n=6). Disease control doesn't always mean tumor shrinkage — includes stable disease. Selection bias toward patients with strong somatostatin receptor expression.
How to read the evidence
Rated moderate: long follow-up (63 months) and meaningful clinical outcomes, but limited by retrospective design, no control group, and small sample size.
When this study was published
Published in 2024, covering a 12-year treatment period (2009-2021). Represents one of the longest follow-up datasets for PRRT in meningiomas.
The bigger picture
This represents the expansion of peptide-targeted radionuclide therapy beyond its established role in neuroendocrine tumors to brain tumors. As more tumor types are found to express somatostatin receptors, PRRT could become a broader oncologic tool, offering treatment for cancers with few other options.
Questions still open
- Should PRRT be considered earlier in the meningioma treatment algorithm, before exhausting surgery and radiation options?
- What is the optimal radioisotope (90Y vs 177Lu) and number of PRRT cycles for meningiomas?
- Could PRRT be combined with other treatments for enhanced meningioma control?
Common questions
Can PRRT treat meningioma brain tumors?
How does PRRT work for brain tumors?
Read the original research
Peptide Receptor Radionuclide Therapy in Advanced Refractory Meningiomas: Efficacy and Toxicity in a Long Follow-up.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 65(9), 1409-1415
Citation
Severi, Stefano; Grassi, Ilaria; Bongiovanni, Alberto; Nicolini, Silvia; Marini, Irene; Arpa, Donatella; Ranallo, Nicoletta; Azzali, Irene; Di Iorio, Valentina; Sarnelli, Anna; Manuela, Monti; Amadori, Elena; Fabbri, Lucia; Bartolini, Daniela; Tosatto, Luigino; Di Meco, Francesco; Gurrieri, Lorena; Riva, Nada; Calabro, Luana; Matteucci, Federica; Paganelli, Giovanni; Sansovini, Maddalena. (2024). Peptide Receptor Radionuclide Therapy in Advanced Refractory Meningiomas: Efficacy and Toxicity in a Long Follow-up.. Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 65(9), 1409-1415. https://doi.org/10.2967/jnumed.123.266956